阿替普酶在不同时间窗溶栓治疗急性脑梗塞的疗效对比

The efficacy and safety of intravenous recombinant tissue plasminogen activator(rt-PA)therapy for patients with acute cerebral infarction in different times

目的探讨阿替普酶用于急性脑梗塞在不同时间窗溶栓治疗的疗效及安全性。方法回顾性分析我院2013年1月1日至2016年12月30日收治的急性脑梗塞溶栓患者88例，按溶栓时间分为3h内溶栓、3~4.5h内溶栓2组，分别测定患者溶栓前、溶栓后24h、3d、7d的NIHSS评分。结果阿替普酶在早期溶栓、晚期溶栓均有效，但早期溶栓并发症或许少于晚期溶栓。结论在3~4.5h时间窗内使用阿替普酶静脉溶栓同样可以取得较好临床疗效，能够显著改善预后，对于溶栓前NIHSS评分>20分的患者溶栓需谨慎评估，或许NIHSS评分>20分的患者溶栓更易出现致死性并发症。

Objective:To investigate the efficacy and safety of intravenous recombinant tissue plasminogen activator(rt-PA)therapy for patients with acute cerebral infarction in different times.Methode:88patients with acute cerebral infarcion from January1,2013to December30,2016were divided into two groups according to the times of rtPA therapy.One is uesed in3hours,the other is in3to4.5hours.Compare the NIHSS score of the two groups before the therapy and in24hours、three days、seven days since the therapy.Results:rt-PA was effective in both group,but perhaps the earlier the rt-PA uesed,the less complications will happen.Conclusion:Use for intravenous recombinant tissue plasminogen activator can also achieve good clinical efficacy in3-4.5hours.It Can significantly improve the prognosis.We need to be careful evaluation the patients whose NIHSS score>20before thrombolysis.Perhaps the patients appear more deadly complications.