不同年龄层次急性脑梗死患者rt-PA静脉溶栓的临床疗效及出血风险对比

Comparison of efficacy and bleeding risk of rt-PA intravenous thrombolysis in patients with acute cerebral infarction of different ages

目的:探究不同年龄层次急性脑梗死(ACI)患者进行重组人组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗的出血风险情况。方法:选取接受治疗的ACI患者153例为研究对象,并根据年龄进行分组,50~65岁患者51例,计为A组;65~75岁患者55例,计为B组;75~80岁患者47例,计为C组,对所有患者行rt-PA静脉溶栓治疗。观察两组的治疗疗效和出血情况,并在治疗前、治疗后1周以及治疗后3周,分别采用神经功能缺损评分(NIHSS)量表、日常生活能力量表(ADL)检测患者神经功能修复情况和日常生活能力。结果:A组总治愈率高于B组、C组,差异均有统计学意义(P<0.05);治疗后1周、3周,A组NIHSS评分较B组、C组显著降低,差异均有统计学意义(P<0.05),A组ADL量表中的Barthel指数较B组、C组显著升高,差异均有统计学意义(P<0.05);A组总出血率低于B组、C组,差异均有统计学意义(P<0.05)。结论:采用rt-PA静脉溶栓治疗急性脑梗死(ACI),治疗效果随年龄的增长而削弱,出血风险随年龄的增长而升高。

Objective To explore the risk of bleeding in patients with acute cerebral infarction(ACI)of different ages undergoing intravenous thrombolytic therapy with recombinant human tissue plasminogen activator(rt-PA).Method 153 patients with ACI who were treated in our hospital were selected and divided into groups according to their age.51 patients aged 50~65 years were included in group A;55 patients aged 65~75 years were included in group B;47 patients aged 75~80 years were included in group C.All patients were treated with rt-PA intravenous thrombolysis.The curative effect and bleeding of the two groups were observed.Before treatment,1 week after treatment and 3 weeks after treatment,the neurological function repair and activities of daily living were detected by NIHSS and ADL respectively.Results The total cure rate of group A was higher than that of group B and C(P<0.05);after 1 and 3 weeks of treatment,NIHSS score of group A was significantly lower than that of group B and group C(P<0.05),Barthel index of group A was significantly higher than that of group B and group C(P<0.05);the total bleeding rate of group A was lower than that of group B and C(P<0.05).Conclusion Intravenous thrombolytic therapy with rt-PA can weaken the therapeutic effect and increase the risk of bleeding.