低剂量阿替普酶治疗高龄脑梗死急性期患者有效性及安全性分析

Efficacy and safety analysis of intravenous thrombolysis with low dose alteplase in elderly patients with acute cerebral infarction

目的观察低剂量阿替普酶(rt-PA)静脉溶栓治疗高龄脑梗死急性期患者的有效性与安全性。方法选取年龄≥80岁的高龄脑梗死急性期患者68例,随机分为观察组及对照组,各34例,分别给予低剂量rt-PA 0.6mg/kg(观察组)及标准剂量rt-PA 0.9mg/kg(对照组)静脉溶栓,最大剂量均不超过90mg。比较两组治疗后24h的美国国立卫生研究院卒中量表(NIHSS)评分、溶栓后1周内出血率、3个月死亡率及90d改良Rankin量表(mRS)评分。结果两组治疗有效性、预后情况、颅内出血发生率比较差异无统计学意义(P>0.05),对照组总出血发生率明显高于观察组,两组比较差异有统计学意义(P<0.05)。结论低剂量rt-PA静脉溶栓治疗高龄脑梗死安全有效,总出血率明显低于标准剂量组。

Objective To investigate the efficacy and safety of intravenous thrombolysis with low dose alteplase in elderly patients with acute cerebral infarction.Methods 68 elderly patients over 80 years old with acute cerebral infarction were randomly divided into observation group and control group,34 cases in each group.Patients in the observation group and the control group were given intravenous thrombolysis with 0.6 mg/kg alteplase and 0.9 mg/kg alteplase respectively,and the maximum dose was less than 90 mg.NIHSS score at 24 h after treatment,bleeding rate within 1 week after thrombolysis,3-month mortality rate and 90 d mRS score were compared between the two groups.Results There were no significant differences in treatment efficacy,prognosis,the incidence of intracranial hemorrhage between the two groups(P>0.05),and the total incidence of hemorrhage in the control group was significantly higher than that in the observation group,with statistically significant differences between the two groups(P<0.05).Conclusion Intravenous thrombolysis with low dose alteplase is safe and effective in elderly patients with acute cerebral infarction,and the total incidence of hemorrage is significantly lower than that of standard dose.