尿激酶与阿替普酶治疗急性脑梗死的疗效及安全性对比

Comparison on the efficacy and safety of urokinase and alteplase in the treatment of acute cerebral infarction

目的 分析尿激酶与阿替普酶治疗急性脑梗死的疗效及安全性。方法 80例急性脑梗死患者,根据治疗方案不同分为对照组和观察组,每组40例。对照组患者接受尿激酶治疗,观察组患者接受阿替普酶治疗。比较两组患者临床疗效,不良事件发生率,治疗前后的美国国立卫生研究院卒中量表(NIHSS)、改良Rankin评分量表(mRS)评分,生活质量评分,溶栓前后凝血功能。结果 观察组临床总有效率97.50%高于对照组的82.50%(P<0.05)。治疗后,两组患者NIHSS评分、mRS评分均较治疗前降低,且观察组NIHSS评分(5.52±0.36)分、mRS评分(2.02±0.18)分均低于对照组的(7.74±0.51)、(2.75±0.25)分(P<0.05)。观察组社会功能评分为(73.78±5.84)分、躯体功能评分为(70.47±5.71)分、认知功能评分为(71.66±5.76)分、情感功能评分为(72.79±5.81)分,均高于对照组的(64.82±5.26)、(61.29±5.18)、(62.35±5.22)、(63.64±5.24)分(P<0.05)。观察组不良事件总发生率5.00%低于对照组的22.50%(P<0.05)。溶栓前,两组患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)对比无差异(P>0.05);溶栓后12 h,观察组患者的PT为(14.41±1.22)s、APTT为(30.42±2.82)s、TT为(14.47±1.25)s,长于对照组的(11.94±1.03)、(27.61±2.33)、(12.08±1.07)s(P<0.05)。结论 采用阿替普酶治疗急性脑梗死患者,其凝血功能得到有效改善,神经缺损情况明显好转,患者生活质量大大提升,且安全性较高,不会出现明显的不良事件,具有较高的临床应用价值。

Objective To analyze the efficacy and safety of urokinase and alteplase in the treatment of acute cerebral infarction.Methods 80 patients with acute cerebral infarction were divided into a control group and an observation group according to different treatment plans,with 40 cases in each group.The control group received urokinase therapy,and the observation group received alteplase therapy.Comparison was made on clinical efficacy,incidence of complications,National Institutes of Health Stroke Scale(NIHSS),modified Rankin scale(mRS)score and quality of life score before and after treatment,coagulation function before and after thrombolysis between the two groups.Results The total clinical effective rate of the observation group was 97.50%,which was higher than the control group's 82.50%(P<0.05).After treatment,NIHSS score and mRS score in both groups were lower than those before treatment;the observation group had NIHSS score of(5.52±0.36)points and mRS score of(2.02±0.18)points,which were lower than(7.74±0.51)and(2.75±0.25)points in the control group(P<0.05).In the observation group,the social functioning score was(73.78±5.84)points,the somatic functioning score was(70.47±5.71)points,the cognitive functioning score was(71.66±5.76)points,and the affective functioning score was(72.79±5.81)points,which were higher than(64.82±5.26),(61.29±5.18),(62.35±5.22),and(63.64±5.24)points in the control group(P<0.05).The total incidence of complications of the observation group was 5.00%,which was lower than the control group's 22.50%(P<0.05).Before thrombolysis,there were no differences in prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)levels between two groups(P>0.05).After 12 h of thrombolysis,PT,APTT and TT in the observation group were(14.41±1.22),(30.42±2.82)and(14.47±1.25)s,which were longer than(11.94±1.03),(27.61±2.33)and(12.08±1.07)s in the control group(P<0.05).Conclusion Clinical treatment of acute cerebral infarction patients with alteplase can effectively improve coagulation function,nerve defects,greatly improve the quality of life of patients.It has high safety with no obvious complications,and contains a high clinical application value.