静脉阿替普酶溶栓治疗脑梗死的有效性及相关指标研究

Efficacy and Related Indexes of Intravenous Alteplase in the Treatment of Cerebral Infarction

目的探讨静脉阿替普酶溶栓治疗脑梗死的有效性及相关指标。方法方便选取该院2017年1月—2018年1月脑梗死患者74例。随机分组,高剂量治疗组采取0.9mg/kg阿替普酶静脉溶栓治疗,低剂量治疗组则采取0.6mg/kg阿替普酶静脉溶栓治疗。比较两组疾病疗效;溶栓之后牙龈出血持续时间、鼻出血持续时间、消化道出血持续时间、颅内出血持续时间、皮下瘀斑持续时间;治疗前后患者缺血区域脑血流等指标水平;总的出血发生例数。结果两组的疗效水平相似,高剂量治疗组是100.00%,低剂量治疗组是97.30%(χ^2=0.157,P>0.05);治疗后两组的心功能均显著改善,改善幅度相似(P>0.05)。低剂量治疗组溶栓之后牙龈出血持续时间、鼻出血持续时间、消化道出血持续时间、颅内出血持续时间、皮下瘀斑持续时间分别是(23.11±1.24)h、(3.22±1.41)h、(3.12±0.24)h、(3.44±1.42)h、(5.13±0.21)h,高剂量治疗组(35.37±2.21)h、(6.37±2.25)h、(4.23±1.52)h、(4.34±2.11)h、(7.23±1.51)h,低剂量治疗组比较有优势(t=6.824、6.811、6.013、6.811、6.021,P<0.05,低剂量治疗组总的出血发生例数3例(13.51%)少于高剂量治疗组14例(37.84%)(χ^2=6.925,P<0.05)。结论0.6mg/kg阿替普酶静脉溶栓治疗脑梗死可更好减少出血事件的发生,缩短出血持续时间,提高治疗的安全性,且在改善血流和神经功能方面作用和高剂量相似,均可获得良好的效果,但安全性更高,值得推广和应用。

Objective To investigate the efficacy and related indicators of intravenous alteplase in the treatment of cerebral infarction.Methods 74 patients with cerebral infarction convenient selection from January 2017 to January 2018 in our hospital.Randomly,the high-dose treatment group received 0.9 mg/kg alteplase intravenous thrombolytic therapy,while the low-dose treatment group received 0.6 mg/kg alteplase intravenous thrombolytic therapy.The efficacy of the two groups of diseases was compared;the duration of gingival bleeding after thrombolysis,the duration of epistaxis,the duration of gastrointestinal bleeding,the duration of intracranial hemorrhage,the duration of subcutaneous ecchymosis;the level of cerebral blood flow in the ischemic area before and after treatment;the number of bleeding cases were all compared.Results The efficacy levels were similar in the two groups.The high-dose treatment group was 100.00%,and the low-dose treatment group was 97.30%(χ^2=0.157,P>0.05).After treatment,the cardiac function was significantly improved,and the improvement was similar(P>0.05).The duration of gingival bleeding,duration of nosebleed,duration of gastrointestinal bleeding,duration of intracranial hemorrhage,and duration of subcutaneous ecchymosis after thrombolysis in the low-dose treatment group were(23.11±1.24 hours,(3.22±1.41)hours,and(3.12±0.24)hours,(3.44±1.42)hours,(5.13±0.21)hours,high-dose treatment group(35.37±2.21 hours,(6.37±2.25)hours,(4.23±1.52)hours,(4.34±2.11)hours,(7.23±1.51)hours,low-dose treatment group had advantages(t=6.824,6.811,6.013,6.811,6.021,P<0.05).The total number of hemorrhagic cases in the low-dose treatment group was 3 cases(13.51%),which was lower than that in the high-dose treatment group 14 cases(37.84%)(χ^2=6.925,P<0.05).Conclusion 0.6mg/kg alteplase intravenous thrombolysis for cerebral infarction can better reduce the occurrence of bleeding events,shorten the duration of bleeding,improve the safety of treatment,and improve the blood flow and nerve function and high dose similarity,can get good results,with high security,it is worth promoting and application.