不同剂量阿替普酶治疗急性轻型缺血性卒中患者的临床效果

Clinical effect of different doses of alteplase in the treatment of patients with acute mild ischemic stroke

目的探讨不同剂量阿替普酶(rt-PA)静脉溶栓治疗急性轻型缺血性卒中(MIS)患者的有效性及安全性。方法回顾性纳入2018年10月至2021年12月在柳州市人民医院接受小剂量rt-PA(0.6 mg/kg,总剂量≤60 mg)静脉溶栓治疗的44例急性MIS患者作为小剂量组,以同时期接受标准剂量rt-PA(0.9 mg/kg,总剂量≤90 mg)静脉溶栓治疗的62例急性MIS患者作为标准剂量组。比较两组的治疗效果。结果两组的临床资料无明显差异(P>0.05)。两组溶栓后7、90 d预后良好[改良Rankin量表(mRS)评分0~2分]占比无明显差异(P>0.05)。两组的溶栓后颅内出血发生率无明显差异(P=0.397)。结论rt-PA静脉溶栓治疗急性MIS患者是安全、有效的,但小剂量溶栓治疗方案可能更好。

Objective To investigate the efficacy and safety of intravenous thrombolysis with different doses of recombinant tissue plasminogen activator(rt-PA)in patients with acute mild ischemic stroke(MIS).Methods Forty-four patients with acute MIS who received low-dose rt-PA(0.6 mg/kg,total dose≤60 mg)intravenous thrombolysis in Liuzhou People's Hospital from October 2018 to December 2021 were retrospectively included as low-dose group,and 62 patients with acute MIS who received standard-dose rt-PA(0.9 mg/kg,total dose≤90 mg)intravenous thrombolysis at the same time were included as standard-dose group.The therapeutic effects of the two groups were compared.Results There was no significant difference in clinical data between the two groups(P>0.05).There was no significant difference in the proportion of good prognosis[Modified Rankin Scale(mRS)score 0-2]between the two groups at 7 and 90 d after thrombolysis(P>0.05).There was no significant difference in the incidence of intracranial hemorrhage after thrombolysis between the two groups(P=0.397).Conclusion Intravenous thrombolysis therapy with rt-PA is safe and effective in patients with acute MIS,but low-dose thrombolysis therapy may be better.