阿替普酶静脉溶栓联合双联抗血小板聚集治疗卒中预警综合征初探

Preliminary study on the efficacy of alteplase intravenous thrombolysis combined with dual antiplatelet in patients with stroke warning syndrome

目的:探讨卒中预警综合征患者采用阿替普酶静脉溶栓联合双联抗血小板聚集治疗(双抗治疗)的安全性及有效性。方法:选择2017年1月至2019年5月复旦大学附属中山医院收治的接受阿替普酶静脉溶栓治疗的卒中预警综合征患者8例,进行为期6个月的随访,分析卒中预警综合征患者采用静脉溶栓联合双抗治疗的疗效与预后。结果:8例患者中,7例有脑血管病危险因素。患者静脉溶栓24 h内发作频率减少,其中6例遗留神经功能缺损。通过给予所有患者双抗治疗结合个体化血压管理,患者病情趋于稳定,发病2周后神经功能缺损改善。发病后6个月内,所有患者预后良好。结论:对于卒中预警综合征患者,给予静脉溶栓联合双抗治疗结合个体化血压管理,对于稳定病情及改善预后有益。

Objective:To explore the safety and efficacy of alteplase intravenous thrombolysis combined with dual antiplatelet therapy in patients with stroke warning syndrome.Methods:From January 2017 to May 2019,8 patients with stroke early warning syndrome were treated with alteplase intravenous thrombolysis in Zhongshan Hospital,Fudan University and followed up for 6 months.The efficacy of intravenous thrombolysis combined with dual antiplatelet therapy and prognosis of the patients were discussed in conjunction with the literature.Results:Seven patients had cerebrovascular disease risk factors.The frequency of attacks decreased within 24 hours of intravenous thrombolysis,but 6 patients had neurological deficits.By giving dual antiplatelet therapy combined with individualized blood pressure management,the patient’s condition was stabilized,and their neurological deficits improved 2 weeks after onset.All patients had a good prognosis 6 months after onset.Conclusions:The alteplase intravenous thrombolysis combined with dual antiplatelet therapy and personalized blood pressure management are beneficial for stabilizing the condition and improving the prognosis of patients with stroke warning syndrome.