阿替普酶静脉溶栓治疗急性脑梗死合并糖尿病的疗效评价

Alteplase Efficacy of Intravenous Thrombolytic Therapy with Alteplase in Patients with Acute Cerebral Infarction Complicated with Diabetes Mellitus

目的探讨阿替普酶静脉溶栓治疗急性脑梗死合并糖尿病的疗效。方法选取98例患者,分为两组,合并糖尿病组52例和不合并糖尿病组46例。均给予阿替普酶静脉溶栓治疗。结果治疗后1 d,21 d的NIHSS评分均明显低于治疗前(P<0.05),且不合并糖尿病组治疗后的NIHSS评分明显低于合并糖尿病组,差异有统计学意义(P<0.05)。治疗后1 d,不合并糖尿病组的NIHSS评分平均6分,合并糖尿病组的NIHSS评分平均7分,两组比较差异无统计学意义(P>0.05),治疗后21 d,不合并糖尿病组的NIHSS评分平均2分,明显低于合并糖尿病组的6分,差异有统计学意义(P<0.05)。治疗后21 d,mRS评分表明,不合并糖尿病组预后良好者43例(93.48%)明显高于合并糖尿病组42例(80.77%),差异有统计学意义(P<0.05)。同时不合并糖尿病组有4例(8.69%)mRS评分0分,完全恢复,但合并糖尿病组无一人恢复至0分。结论发现糖尿病使脑梗死患者的静脉溶栓效果获益降低,但仍可以在阿替普酶溶栓后明显获益。

Objective Objective to investigate the efficacy of intravenous thrombolytic therapy with alteplase in patients with acute cerebral infarction complicated with diabetes mellitus. Methods 98 patients were selected and divided into two groups, 52 cases with diabetes mellitus and 46 cases without diabetes mellitus.All patients were treated with intravenous thrombolytic therapy with intravenous thrombolytic therapy. All patients were given intravenous thrombolysis with alteplase. Results The scores of NIHSS at the 1 st day and the 21 st day after the treatment were significantly lower than those before treatment(P<0.05), and the scores of NIHSS in non-diabetic group were significantly lower than those in diabetic group(P<0.05). At the 1 st day after the treatment, the average NIHSS score of the non-diabetic group was 6 points, and that of the diabetic group was 7 points. There was no significant difference between the two groups(P>0.05).At the 21 st day after the treatment, the average score of NIHSS in the non-diabetic group was 2 points, significantly lower than that in the diabetic group(6 points, P<0.05).At the 21 st day after the treatment, the mRS score showed that 43 patients(93.48%) with good prognosis in the non-diabetic group were significantly higher than 42 patients(80.77%) with diabetes mellitus(P<0.05).At the same time, 4 patients(8.69%) without diabetes mellitusrecovered to 0 point,they recovered completely, but none of the patients with diabetes mellitus recovered to 0 point. Conclusions Diabetes mellitus with cerebral infarction can reduce the benefit of intravenous thrombolysis in patients but it can still benefit significantly from alteplase thrombolysis.