阿替普酶与尿激酶初始溶栓对中老年急性脑梗死患者的疗效分析

Analysis of Alteplase and Urokinase Initial Thrombolysis in Middle-Aged and Aged Patients with Acute Cerebral Infarction

目的分析阿替普酶和尿激酶初始溶栓对急性脑梗死中老年患者的疗效。方法回顾性分析2019年3月至2021年11月宜阳县人民医院收治的78例急性脑梗死中老年患者的临床资料,依据不同治疗方式分成对照组(经尿激酶开展初始溶栓)和观察组(经阿替普酶开展初始溶栓),各39例。比较两组治疗有效率,治疗前后神经功能和生活质量得分,治疗前后凝血酶时间(TT)、凝血酶原时间(PT)、活化部分的凝血活酶时间(APTT)及纤维蛋白原(FIB)等凝血功能指标水平,治疗期间各类并发症出现情况。结果观察组有效率(94.87%)高出对照组(71.79%),差异有统计学意义(P<0.05)。治疗前,两组在神经功能和生活质量得分方面,差异无统计学意义(P>0.05);治疗后,两组神经功能得分均较前降低,生活质量得分均较前升高,差异有统计学意义(P<0.05),且观察组神经功能得分低于对照组,生活质量得分高于对照组,差异有统计学意义(P<0.05)。治疗前,两组在TT、PT、APTT、FIB等凝血功能指标方面,差异无统计学意义(P>0.05);治疗后,两组TT、PT、APTT水平均较前延长,FIB水平均较前降低,差异有统计学意义(P<0.05),且观察组TT、PT、APTT水平长于对照组,FIB水平低于对照组,差异有统计学意义(P<0.05)。观察组颅内出血、消化道出血、蛛网膜下腔位置出血等并发症出现少于对照组,差异有统计学意义(P<0.05)。结论和尿激酶初始溶栓相比,对急性脑梗死中老年患者采取阿替普酶初始溶栓疗效更佳,能改善其神经功能和凝血功能,提高其生活质量,减少出血等并发症出现,安全性佳。

Objective To analyze the effects of alteplase and urokinase initial thrombolysis in middle-aged and aged patients with acute cerebral infarction.Methods Clinical data about 78 middle-aged and aged patients with acute cerebral infarction treated in our hospital from March 2019 to November 2021 was retrospectively analyzed.According to different therapies,patients were divided into control group(N=39,urokinase initial thrombolysis)and observation group(N=39,alteplase initial thrombolysis).Treatment outcomes were appraised through the effective treatment rate,neurological function and life quality scores,coagulation function indicators like thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)as well as treatment complications were compared between two groups.Results The effective rate in the observation group(94.87%)was higher than control group(71.79%)(P<0.05);Before therapy,the neurological function and life quality scores between groups were not significantly different(P>0.05);After therapy,the neurological function scores for two groups were declined while the life quality scores were increased(P<0.05);The neurological function scores in the observation group were lower than control group while the life quality scores were higher than control group(P<0.05);Before therapy,TT,PT,APTT and FIB values between groups were not significantly different(P>0.05);After therapy,TT,PT and APTT for two groups were extended while FIB contents were declined(P<0.05);TT,PT and APTT in the observation group were longer than control group while FIB content was lower than control group(P<0.05);The treatment complications like intracranial hemorrhage,gastrointestinal bleeding and subarachnoid hemorrhage in the observation group were fewer than control group(P<0.05).Conclusion Compared with urokinase initial thrombolysis,alteplase initial thrombolysis can better reduce the treatment complications,and improve the neurological function,coagulation function,life quality and treatment safety for middle-aged and aged patients with acute cerebral infarction.It is worthy of clinical promotion and application.