阿替普酶静脉溶栓治疗急性轻型缺血性卒中的短期效果及安全性分析

Short-term Efficacy and Safety Analysis of Intravenous Thrombolytic Therapy with Alteplase in Patients with Acute Minor Ischemic Stroke

目的:观察阿替普酶静脉溶栓治疗急性轻型缺血性卒中(MIS)的短期效果及安全性。方法:回顾性分析本院2018年6月-2020年12月收治的急性MIS患者的一般资料,根据是否行溶栓治疗分为研究组38例和对照组35例,其中研究组采用阿替普酶静脉溶栓,对照组不行溶栓治疗。观察两组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分变化,采用改良Rankin量表(mRS)评估患者预后,同时记录患者治疗90 d内非症状性颅内出血(非SICH)、症状性颅内出血(SICH)发生情况和复发情况。结果:治疗14、90 d后,研究组NIHSS评分均低于对照组(P<0.05);研究组mRS评分0~2分32例,预后良好率为84.2%,显著高于对照组的62.9%,差异有统计学意义(P<0.05);两组患者治疗90 d内均无死亡病例,两组治疗90 d内非SICH、SICH、复发例数比较,差异均无统计学意义(P>0.05)。结论:阿替普酶静脉溶栓治疗急性MIS患者安全性较高,可有效改善患者神经功能损伤程度,促进预后。

Objective:To observe the short-term efficacy and safety of Alteplase intravenous thrombolysis in the treatment of acute minor ischemic stroke(MIS).Method:The clinical data of acute MIS patients in our hospital from June 2018 to December 2020 were analyzed,according to whether or not thrombolytic therapy was received,they were divided into study group(38 cases)and control group(35 cases).The study group received intravenous thrombolytic therapy with Alteplase,while the control group did not receive thrombolytic therapy.The changes of NIHSS score before and after treatment in the two groups were observed,and the prognosis of the patients was evaluated with modified Rankin Scale(mRS),the incidence of asymptomatic hemorrhage,symptomatic intracranial hemorrhage(SICH),recurrence rate were recorded within 90 d of treatment.Result:After 14 and 90 d of treatment,the NIHSS scores in the study group were lower than those in the control group(P<0.05).The mRS score of 32 patients in the study group was 0-2,and the rate of good prognosis was 84.2%,which was significantly higher than 62.9%of the control group,with statistical significance(P<0.05).The number of asymptomatic bleeding,symptomatic bleeding and recurrence cases in the two groups within 90 d of treatment,the differences were not statistically significant(P>0.05).Conclusion:Intravenous thrombolysis with Alteplase in patients with acute MIS is safe and can effectively improve the degree of neurological damage and promote the prognosis of patients.