觉醒型卒中患者静脉溶栓的疗效及安全性评估

Efficacy and safety of intravenous thrombolysis in patients with wake-up stroke

目的观察经过影像选择的觉醒型卒中(WUS)患者静脉溶栓的疗效及安全性。方法选择2015年1月至5月适宜的WUS患者共13例给予静脉溶栓治疗,同期未行静脉溶栓的患者21例作为对照,治疗7 d时应用美国国立卫生研究院卒中量表(NIHSS)评分及90 d时应用改良的Rankin量表(MRs评分)评价患者的近期疗效及预后。结果两组患者性别、年龄、收缩压、入室时血糖、房颤、高脂血症、吸烟等,及入院时NIHSS评分、卒中分型比较差异均无统计学意义(P均>0.05);治疗7 d时早期治疗有效率治疗组(38.46%)较对照组(28.57%)有所提高,但差异无统计学意义(P=0.7094);90 d时预后良好率治疗组为46.15%,对照组为23.81%,治疗组较对照组有所提高,但差异无统计学意义(P=0.2619)。两组均无症状性颅内出血发生。结论经过选择的WUS患者静脉溶栓治疗是安全有效的,能否在改善患者的早期疗效和远期预后方面获益,有待扩大样本量进一步探讨。

Objective To observe the efficacy and safety of intravenous thrombolytic therapy in patients with wake-up stroke(WUS)selected by imaging.Methods Thirteen patients treated with intravenous thrombolysis from January to May 2015 were designed as treatment group.Twenty-one patients without intravenous thrombolysis during the same period were selected as control group.The short-term efficacy and prognosis of patients were evaluated by National Institutes of Health Stroke Scale(NIHSS)score at 7 days of treatment and the modified Rankine scale(MRs)at 90 days of treatment.Results There were no significant differences in gender,age,systolic blood pressure,blood sugar at admission,atrial fibrillation,hyperlipidemia,smoking,NIHSS score at admission and stroke type between two groups(all P>0.05).At 7 days,the effective rate of early treatment was higher in treatment group(38.46%)than that in control group(28.57%),but there was no significant difference(P=0.7094);at 90 days,the good prognosis rate was 46.15%in treatment group and 23.81%in control group,and there was no significant difference(P=0.2619).No symptomatic intracranial hemorrhage occurred in both groups.Conclusions Intravenous thrombolytic therapy is safe and effective for selected patients with WUS.Whether it can improve patients′early efficacy and long-term prognosis,further expansion of sample size is needed.