心源性脑梗死与非心源性脑梗死患者rt-PA静脉溶栓治疗效果比较

Comparison of clinical effects of rt-PA intravenous thrombolysis therapy in patients with cardiogenic cerebral infarction and non-cardiac cerebral infarction

目的比较重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗对非心源性脑梗死与心源性脑梗死患者的临床疗效。方法选取2016年7月至2018年5月于武陟县中医院就诊的74例心源性脑梗死患者为A组,74例非心源性脑梗死患者为B组。两组患者均接受rt-PA静脉溶栓治疗。采用美国国立卫生研究院卒中量表(NIHSS)评估两组治疗前、治疗后2 h、治疗后1 d、治疗后1周神经功能缺损程度,对比两组并发症发生情况。结果治疗后2 h、治疗后1 d、治疗后1周,两组NIHSS评分均呈下降趋势,组间比较差异无统计学意义(均P>0.05)。A组脑疝、皮肤黏膜出血发生率及并发症总发生率均高于B组,差异有统计学意义(均P<0.05)。结论 rt-PA静脉溶栓治疗在改善心源性脑梗死与非心源性脑梗死患者神经功能方面效果相当,心源性脑梗死患者溶栓后并发症(皮肤黏膜出血、脑疝等)发生率较高。

Objective To compare the clinical effects of recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis in patients with non-cardiac cerebral infarction and cardiogenic cerebral infarction.Methods Seventy-four patients with cardiogenic cerebral infarction who were admitted to Wuzhi County Traditional Chinese Medicine Hospital from July 2016 to May 2018 were selected as group A,and 74 patients with non-cardiac cerebral infarction were group B.All the patients received rt-PA intravenous thrombolysis therapy.The National Institute of Health Stroke Scale(NIHSS)was used to evaluate the degree of neurological deficits before treatment,2 h after treatment,1 d after treatment,and 1 week after treatment.The complications of the two groups were compared.Results The NIHSS scores of the two groups showed a downward trend 2 h,1 d and 1 week after treatment.There was no significant difference between the two groups(all P>0.05).The incidence of cerebral hernia,skin mucosal bleeding,and the total incidence of complications in group A were higher than those in group B(all P<0.05).Conclusion The clinical effect of rt-PA intravenous thrombolysis in patients with cardiogenic cerebral infarction is commensurate with that in patients with non-cardiac cerebral infarction.Patients with cardiogenic cerebral infarction have a higher incidence of complications after thrombolysis.