阿替普酶静脉溶栓治疗急性脑梗死早期疗效不佳的原因初探

Preliminary analysis of the early curative effect of Alteplase for intravenous thrombolytic therapy for acute cerebral infarction

目的探讨导致阿替普酶静脉溶栓早期疗效不佳的因素。方法回顾分析接受阿替普酶溶栓治疗的90例急性脑梗死患者临床数据，根据患者溶栓后24h美国国立卫生研究院神经功能缺损评分（NIHSS评分）减少是否＞3分，分为溶栓有效组和溶栓无效组，用单因素和多因素回归比较2组临床数据的差异。结果单因素分析结果显示溶栓后早期疗效与3个月预后相关（P=0.000）。分析显示溶栓前收缩压与溶栓后早期疗效显著相关（P=0.009），与是否存在慢性房颤关系密切。结论溶栓后早期疗效好者3个月的预后好；溶栓前收缩压低者和非慢性房颤者的溶栓后早期疗效好。

Objective To investigate the early curative effect factors of Alteplase for intravenous thrombolysis.Methods Clinical data of90patients with acute cerebral infarction for Alteplase treatment was retrospectively analyzed,according the NIHSS scores,patients were divided into the thrombolysis effective group and the thrombolysis ineffective group,the differences in clinical data of the two groups were compared by single factor and multifactor regression.Results Results of univariate analysis showed that the early curative effect after thrombolysis associated with3months prognosis(P=0.000).Analysis showed that systolic blood pressure before thrombolysis is closely related to early curative effect after thrombolysis(P=0.009).Conclusion The prognosis of the patients for3months after thrombolysis is good,and the early curative effect of patients who has low systolic blood pressure before thrombolytic therapy and patients with non chronic atrial fibrillation received good outcomes after the thrombolysis.