超高龄急性缺血性脑卒中不同剂量阿替普酶静脉溶栓治疗短期疗效、血凝状态分析

Analysis of Short-term Efficacy and Blood Coagulation Status of Different Doses of Alteplase Intravenous Thrombolytic Therapy in Hyperelderly Acute Ischemic Stroke

目的:研究超高龄急性缺血性脑卒中(AIS)患者给予不同剂量阿普替酶静脉溶栓的短期疗效及血凝状态。方法:以2016年1月~2018年2月某院收治超高龄AIS患者共90例为研究对象,使用抽签法随机分为对照组和实验组。对照组使用高剂量阿替普酶静脉溶栓,剂量为0.9mg/Kg;实验组使用低剂量阿替普酶静脉溶栓,剂量为0.6mg/Kg。对比两组患者的短期疗效及血凝状态。结果:治疗前、治疗后两组患者NIHSS、CSS及MRS评分对比无明显差异(P>0.05),差异无统计学意义;实验组患者APTT、PT、TT、INR及D-dimer低于对照组,FIB高于对照组(P<0.05),差异有统计学意义;两组患者药物相关不良反应对比无明显差异(χ2=1.142,P=0.285>0.05),差异无统计学意义。结论:对超高龄急性缺血性脑卒中患者给予低剂量阿替普酶静脉溶栓可以在维持治疗效果前提下,降低对血凝功能影响,值得应用。

Objective:To study the short-term efficacy and blood coagulation status of different doses of alteplase intravenous thrombolytic therapy in hyperelderly acute ischemic stroke(AIS).Methods:A total of 90 cases of hyperelderly AIS admitted and treated in a hospital from January 2016 to February 2018 were studied.Patients in the control group were given intravenous thrombolysis with a high dose of ateptase at 0.9mg/kg.The experimental group were given intravenous thrombolysis with a low dose of alteplase was administere at 0.6mg/kg.Results:There was no significant difference in the scores of NIHSS,CSS and MRS between the two groups before and after treatment,and the difference was not statistically significant(P>0.05).APTT,PT,TT,INR and D-dimer in the experimental group were lower than the control group,and FIB was higher than the control group(P<0.05),with statistically significant difference.There was no significant difference in drug-related adverse reactions between the two groups(χ2=1.142,P=0.285>0.05),the difference was not statistically significant.Conclusion:Low-dose intravenous thrombolysis with alteplase can reduce the influence on blood coagulation function in the patients with hyperelderly acute ischemic stroke under the premise of maintaining the therapeutic effect.It is worthy of application.