阿替普酶与尿激酶溶栓对超早期急性脑梗死患者神经功能的影响

Influence of Alteplase and Urokinase thrombolysis on neurological function in patients with ultra-early acute cerebral infarction

目的研究阿替普酶和尿激酶溶栓在治疗超早期急性脑梗死患者首次发病时对其神经功能所产生的影响,为求在临床上应用何种方法有效治疗超早期脑梗死寻求最佳途径。方法选取我院2017年1月～2018年3月收治的91例急性脑梗死首次发病患者作为研究对象,以抽选方式随机分为实验组(46例)和对照组(45例)。实验组患者行阿替普酶治疗,对照组患者行尿激酶溶栓治疗,观察两组患者治疗前及治疗后1、7、14 d的美国国立卫生研究院卒中量表(NIHSS)评分以及不良反应发生情况、神经预后效果。结果两组患者治疗前的NIHSS评分比较,差异无统计学意义(P>0.05);两组患者治疗后1、7、14 d的NIHSS评分均低于治疗前,差异有统计学意义(P<0.05);实验组患者治疗后1、7、14 d的NIHSS评分均低于对照组,差异有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05);实验组的预后良好率显著高于对照组,而预后不良率则低于对照组(P<0.05)。结论对于超早期脑梗死患者而言,使用阿普替酶和尿激酶溶栓进行治疗均有较好的效果,但也均有可能发生不良反应,因此在治疗过程中应十分注意;与尿激酶溶栓相比,阿替普酶对患者的神经功能所产生的影响较小,因此可以在临床上推广应用。

Objective To study the influence of Alteplase and Urokinase thrombolysis on the neurological function of patients with super-early acute cerebral infarction at the first onset,and to find the best way to effectively treat super-early cerebral infarction in clinic.Methods A total of 91 patients with the first onset of acute cerebral infarction in our hospital from January 2017 to March 2018 were selected and randomly divided into the experimental group(46 cases)and the control group(45 cases)by selection.The experimental group was treated with Alteplase,while the control group was treated with Urokinase thrombolysis.The NIHSS scores before treatment and 1,7 and 14 days after treatment,adverse reactions and neurological outcomes were observed between the two groups.Results There was no significant difference in the NIHSS scores between the two groups before treatment(P>0.05).The NIHSS scores of the two groups at 1,7 and 14 days after treatment were lower than those before treatment,with significant difference(P<0.05).The NIHSS scores of the experimental group at 1,7 and 14 days after treatment were lower than those of the control group,with significant difference(P<0.05).There was no significant difference in the total incidence of adverse reactions between the experimental group and the control group(P>0.05).The rate of good prognosis in the experimental group was significantly higher than that in the control group,but the rate of poor prognosis was lower than that in the control group(P<0.05).Conclusion For patients with ultra-early cerebral infarction,the use of Alteplase and Urokinase thrombolysis has a good effect,but there are also possible adverse reactions,therefore,great attention should be paid in the course of treatment.Compared with Urokinase thrombolysis,the use of Alteplase has less impact on the neurological function of patients,therefore,it can be popularized and applied in clinic.