0.6mg/kg阿替普酶治疗DWI-Flair错配的不明发病时间缺血性卒中的效果

The Effect of 0.6mg/kg Alteplase in the Treatment of Ischemic Stroke with Unknown Onset Time of DWI-Flair Mismatch

目的分析0.6 mg/kg阿替普酶治疗弥散加权成像(DWI)-液体衰减反转恢复(Flair)错配的不明发病时间缺血性卒中的效果。方法选取信阳市第三人民医院神经内科2019年1月至2020年1月收治的60例DWI-Flair错配的不明发病时间缺血性卒中患者为研究对象,利用随机数字表法分为两组,每组各30例。对照组采取0.9 mg/kg阿替普酶治疗,观察组采取0.6 mg/kg阿替普酶治疗,比较两组患者的症状性颅内出血发生率、死亡率、改良Rankin量表评估结果、脑血流动力学指标(平均流速、最大峰值流速、血管搏动指数、血管阻力指数)差异。结果观察组症状性颅内出血发生率、死亡率、改良Rankin量表评估结果与对照组比较,差异无统计学意义(P>0.05)。治疗前两组患者脑血流动力学指标(平均流速、最大峰值流速、血管搏动指数、血管阻力指数)比较,差异无统计学意义(P>0.05),治疗后两组平均流速、最大峰值流速高于各组治疗前,血管搏动指数、血管阻力指数低于各组治疗前,差异有统计学意义(P<0.05),但观察组与对照组各指标比较,差异无统计学意义(P>0.05)。结论在DWI-Flair错配的不明发病时间缺血性卒中患者治疗中,0.6 mg/kg阿替普酶可替代0.9 mg/kg阿替普酶加以使用。

Objective To analyze the effect of 0.6 mg/kg alteplase in the treatment of ischemic stroke with an unknown onset time of diffusion-weighted imaging(DWI)-fluid attenuation inversion recovery(Flair)mismatch.Methods A total of sixty patients with ischemic stroke with unknown onset time with DWI-Flair mismatch admitted to the Department of Neurology of the Third People’s Hospital of Xinyang City from January 2019 to January 2020 were selected as the research objects.They were divided into two groups by the random number table method,with 30 cases in each group.The control group was treated with 0.9 mg/kg alteplase,and the observation group was treated with 0.6 mg/kg alteplase.The incidence of symptomatic intracranial hemorrhage,mortality,evaluation results of the modified Rankin scale,and cerebral hemodynamic indexes(mean fiow velocity,maximum peak fiow velocity,vascular pulsation index,and vascular resistance index)were compared between the two groups.Results There was no significant difference between the observation group and the control group in the incidence of symptomatic intracranial hemorrhage,mortality,and the evaluation results of the modified Rankin scale(P>0.05).There was no significant difference in cerebral hemodynamic indexes(mean fiow velocity,maximum peak fiow velocity,vascular pulsation index,and vascular resistance index)between the two groups before treatment(P>0.05).After treatment,the mean and maximum peak fiow velocity of the two groups were higher than before treatment,while the vascular pulsation index and vascular resistance index were lower than before treatment,the difference was statistically significant(P<0.05),but there was no statistically significant difference between the observation group and the control group(P>0.05).Conclusion The 0.6 mg/kg alteplase can be used instead of 0.9 mg/kg alteplase in the treatment of ischemic stroke patients with an unknown onset time of DWI-Flair mismatch.