阿替普酶溶栓治疗急性脑梗死的疗效及安全性研究

Study on efficacy and safety of thrombolytic therapy with alteplase in acute cerebral infarction

目的研究阿替普酶溶栓治疗急性脑梗死的临床疗效及安全性。方法140例急性脑梗死患者,以随机数字表法分为对照组和观察组,各70例。对照组患者给予常规治疗联合尿激酶溶栓治疗,观察组给予常规治疗联合阿替普酶溶栓治疗。比较两组患者的治疗效果,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分,出血性事件发生率,不良反应发生率。结果治疗24 h后,观察组总有效率为95.71%,高于对照组的82.86%,差异具有统计学意义(P<0.05)。治疗前,两组NIHSS评分比较差异无统计学意义(P>0.05);治疗3 h、24 h、7 d后,观察组NIHSS评分分别为(10.3±1.0)、(7.5±0.7)、(5.4±0.5)分,均低于对照组的(12.0±1.3)、(9.6±1.0)、(7.8±0.7)分,差异具有统计学意义(P<0.05)。两组出血性转化(HT)发生率及其余出血性事件发生率比较差异无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论阿替普酶溶栓治疗急性脑梗死疗效显著且较安全,HT发生率及其他出血事件发生风险均较低,更有助于促进患者神经功能修复,值得临床推广。

Objective To study the clinical efficacy and safety of thrombolytic therapy with alteplase in acute cerebral infarction.Methods A total of 140 patients with acute cerebral infarction were divided into control group and observation group by random numerical table,with 70 cases in each group.The control group was treated with conventional therapy and urokinase intravenous thrombolysis,and the observation group was treated with conventional therapy and alteplase thrombolysis.The therapeutic effect,the National Institutes of Health stroke scale(NIHSS)score before and after treatment,the incidence of hemorrhagic events,and the incidence of adverse reactions were compared between the two groups.Results After 24 h of treatment,the total effective rate in the observation group was 95.71%,which was higher than 82.86%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in NIHSS scores between the two groups(P>0.05).After 3 h,24 h and 7 d of treatment,the NIHSS scores of the observation group were(10.3±1.0),(7.5±0.7),and(5.4±0.5)points,which were lower than(12.0±1.3),(9.6±1.0),and(7.8±0.7)points of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of hemorrhagic transformation(HT)and other hemorrhagic events between the two groups(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Intravenous thrombolysis with alteplase is effective and safe in patients with acute cerebral infarction,with low incidence of HT,hemorrhagic events.It is more helpful to promote the recovery of neurological function in patients,and is worthy of clinical promotion.