超早期应用阿替普酶静脉溶栓治疗高龄脑梗患者的临床效果与安全性研究

Clinical Efficacy and Safety of Intravenous Thrombolysis with Ateplase in the Treatment of Elderly Patients with Cerebral Infarction

目的探讨高龄脑梗超早期应用阿替普酶静脉溶栓治疗的临床效果及安全性。方法选择我院2017年1月至2018年8月收治高龄脑梗死患者64例,按照治疗方法不同分为行常规治疗对照组(n=34)与溶栓治疗实验组(n=30)。所有患者入院后均开展生化检查,头颅CT,心电图及血常规检验等,对照组采用常规方法治疗,实验组采用阿替普酶静脉溶栓方案干预,观察治疗前、治疗6 h、治疗24 h以及治疗7 d后患者的神经功能缺损(NIHSS)评分。对比临床疗效,对比两组患者用药不良反应。结果干预前,两组患者NIHSS评分对比无显著差异,P>0.05,治疗6 h、治疗24 h以及治疗7 d后,实验组NIHSS评分明显低于对照组,P<0.05。实验组治疗总有效率及显效率均明显高于对照组,P<0.05,且两组未见致死病例。结论在高龄脑梗超早期患者的临床治疗中,如符合溶栓条件,推荐使用阿替普酶静脉溶栓方案,以提高临床疗效。

Objective To investigate the clinical effect and safety of intravenous thrombolysis with ateplase in the super early stage of cerebral infarction in the elderly.Methods 64 elderly patients with cerebral infarction were selected from January 2017 to August 2018 in our hospital.They were divided into routine treatment control group(n=34)and thrombolytic treatment experimental group(n=30)according to different treatment methods.All patients underwent biochemical examination,cranial CT,electrocardiogram and blood routine examination after admission.The control group was treated with routine methods,while the experimental group was treated with intravenous thrombolysis of ateplase.The scores of neurological deficits(NIHSS)were observed before treatment,6 hours after treatment,24 hours after treatment and 7 days after treatment.The clinical efficacy and adverse drug reactions were compared between the two groups.Results Before intervention,there was no significant difference in NIHSS score between the two groups,P>0.05.After6 hours,24 hours and 7 days of treatment,the NIHSS score of the experimental group was significantly lower than that of the control group(P<0.05).The total effective rate and marked effective rate in the experimental group were significantly higher than those in the control group(P<0.05),and there were no fatal cases in the two groups.Conclusion In the clinical treatment of Super-early cerebral infarction in the elderly,if the thrombolytic conditions are met,the intravenous thrombolytic regimen of ateplase is recommended to improve the clinical efficacy.