80岁以上急性缺血性卒中患者静脉溶栓治疗的有效性和安全性分析

Efficacy and safety of intravenous thrombolysis in patients over 80 years of age with acute ischemic stroke

目的探讨重组组织型纤溶酶原激活剂治疗80岁以上急性缺血性卒中患者的有效性和安全性。方法收集2016年2月至2018年2月在我院神经内科住院的发病<4.5 h的急性缺血性脑卒中溶栓患者57例,收集患者一般情况和既往病史。根据年龄分组,年龄≥80岁(80岁以上组)20例,年龄<80岁(80岁以下组)37例。治疗前和治疗后NIHSS评分判断疗效,比较两组颅内出血发生率,90 d时随访改良Rankin量表判断预后。结果 80岁以下组和80岁以上组治疗后14 d有效率分别为64.9%和75.0%(P=0.43),症状性颅内出血发生率分别为2.7%和5.0%(P=0.65),病死率分别为2.7%和15%(P=0.08),预后良好率分别为56.8%和50%(P=0.63),差异均无统计学意义。结论静脉溶栓用于治疗80岁以上急性缺血性卒中患者安全有效。

Objective To analyze the efficacy and safety of recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis in patients over 80 years of age with acute ischemic stroke.Methods Fifty-seven ischemic stroke patients with rt-PA intravenous thrombolysis hospitalized in Changzhou NO.2 People’s Hospital from Feb.2016 to Feb.2018 were collected.They were divided into 2 groups according to age,20 cases with age≥80 years old in over 80 years old group and 37 cases with age<80 years old in under 80 years old group.Their NIHSS scores before and on day 14 after thrombolytic treatment,incidence of intracranial hemorrhage(ICH)and symptomatic ICH mortality and modified Rankin scale scores during the 90 d follow-up period were compared.Results The effective rate was 64.9%and 75%(P=0.43)at 14 d after thrombolytic treatment in the group under and over 80 years old,the incidence of symptomatic ICH were 2.7%and 5.0%(P=0.65)respectively,and the mortality rate was 2.7%and 15%(P=0.08).After follow-up of 90 d,the prognosis rates were 56.8%and 50.0%respectively(P=0.08),all of the differences were not statistically significant.Conclusion Intravenous thrombolysis is effective and safe in patients over 80 years of age with acute ischemic stroke.