心源性脑梗死与非心源性脑梗死静脉溶栓治疗的疗效及安全性对比研究

A comparative study of the efficacy and safety of intravenous thrombolysis for cardiogenic cerebral infarction and non-cardiogenic cerebral infarction

目的比较心源性脑梗死(CCI)与非心源性脑梗死(NCI)患者应用重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗的疗效及安全性。方法采用回顾性研究,收集2019年1月—2020年12月合浦县人民医院神经内科172例行rt-PA静脉溶栓治疗的急性期脑梗死患者的临床资料,其中CCI组(60例)和NCI组(112例)。比较两组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分和不良事件发生情况的差异。结果相比两组治疗前,治疗后两组各时间点NIHSS量表评分和mRS量表评分均显著下降(P<0.001);治疗后两组之间NIHSS量表评分和mRS量表评分比较差异无统计学意义(P>0.05);两组之间不良事件发生情况相比较,差异均无统计学意义(P>0.05)。结论CCI和NCI患者于发病4.5 h内行rt-PA静脉溶栓治疗后疗效相当,发生出血的风险也相当。

Objective To compare the efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA)in patients with cardiogenic cerebral infarction(CCI)and non-cardiogenic cerebral infarction(NCI).Methods A retrospective study was conducted.We collected the clinical data of 172 patients with acute cerebral infarction who received intravenous thrombolysis with rt-PA in the Department of Neurology,Hepu People’s Hospital from January 2019 to December 2020.They were divided into a CCI group(n=60)and a NCI group(n=112).We compared the differences in the score of the National Institutes of Health Stroke Scale(NIHSS),the score of modified Rankin Scale(mRS)and the incidence of adverse events between two groups before and after treatment.Results After treatment,the NIHSS scores and the MRS scores of both groups at each time point significantly decreased in comparison with those before treatment(P<0.001).After treatment,there was no significant difference in the NIHSS score and the MRS score between two groups(P>0.05).There was no statistically significant difference in the incidence of adverse events between two groups(P>0.05).Conclusion Within 4.5 h of the disease attack,intravenous thrombolysis with rt-PA has similar efficacy and risk of bleeding on patients with CCI and patients with NCI.