阿替普酶不同剂量治疗急性缺血性脑卒中的疗效对照评定

Comparison of the Efficacy of Different Doses of Alteplase in the Treatment of Acute Ischemic Stroke

目的探讨阿替普酶不同剂量治疗急性缺血性脑卒中的疗效对照。方法将该院方便收集2017年2月—2018年2月的78例急性缺血性脑卒中患者,所有患者选择阿替普酶溶栓治疗,随机分组,常规剂量阿替普酶治疗组用常规剂量阿替普酶治疗,低剂量阿替普酶治疗组用低剂量阿替普酶治疗。比较两组急性缺血性脑卒中疗效;平均治疗费用;治疗前后NHISS神经功能缺损积分、生活独立能力BARTHEL、生存质量QOL量表评分;并发症发生率。结果低剂量阿替普酶治疗组急性缺血性脑卒中疗效和常规剂量阿替普酶治疗组均是94.87%(χ2=0.000,P>0.05)。治疗前后,低剂量阿替普酶治疗组急性缺血性脑卒中患者NHISS神经功能缺损积分、生活独立能力BARTHEL、生存质量QOL量表评分和常规剂量阿替普酶治疗组之间差异无统计学意义(P>0.05)。低剂量阿替普酶治疗组平均治疗费用更少(t=5.812,P<0.05),低剂量阿替普酶治疗组平均治疗费用是(1411.56±143.12)元,常规剂量阿替普酶治疗组平均治疗费用是(1992.67±225.21)元。低剂量阿替普酶治疗组急性缺血性脑卒中并发症发生率和常规剂量阿替普酶治疗组之间差异无统计学意义(χ2=0.345,P>0.05),低剂量阿替普酶治疗组有1例出现不良反应,常规剂量阿替普酶治疗组有2例出现不良反应。结论急性缺血性脑卒中患者实施常规剂量和低剂量阿替普酶治疗效果理想,两者均可有效改善患者的神经功能,并改善日常生活能力,但低剂量使用可减少医疗费用。

Objective To investigate the efficacy of different doses of alteplase in the treatment of acute ischemic stroke.Methods Convenient selected a total of 78 patients with acute ischemic stroke from February 2017 to February 2018 were enrolled in the hospital.All patients were treated with alteplase thrombolytic therapy,randomized,and routine doses of alteplase were used routinely.The dose was treated with alteplase,and the low-dose alteplase group was treated with low-dose alteplase.The efficacy of the two groups in the treatment of acute ischemic stroke was compared;the average treatment cost;the score of NHISS neurological deficit before and after treatment,the independent living ability BARTHEL,the quality of life QOL scale score;the incidence of complications.Results The efficacy of low-dose alteplase in the treatment of acute ischemic stroke and conventional dose of alteplase was 94.87%(χ2=0.000,P>0.05).Before and after treatment,there was no statistically significant difference in NHISS neurological deficit score,life independent ability BARTHEL,quality of life QOL scale score between conventional dose of alteplase and the low-dose alteplase group treatment in the acute ischemic stroke(P>0.05).The average treatment cost was lower in the low-dose alteplase group(t=5.812,P<0.05),and the average treatment cost in the low-dose alteplase group was(1411.56±143.12)yuan.The average treatment cost of the conventional dose of alteplase treatment group was(1992.67±225.21)yuan.There was no statistically significant difference between the incidence of acute ischemic stroke and the conventional dose of alteplase in the low-dose alteplase group(χ2=0.345,P>0.05).One patient had an adverse reaction in the low-dose alteplase group,and two patients had a side-effect in the conventional dose of alteplase.Conclusion Patients with acute ischemic stroke are treated with conventional and low-dose alteplase.Both can effectively improve the neurological function of patients and improve their daily living ability,but low-dose use can reduce medical expenses.