急诊rt-PA动脉溶栓联合丹红注射液治疗急性脑梗死的临床研究

Clinical Study on Intra-arterial Thrombolysis with Rt-PA and Dan Red Injection for Acute Cerebral Infarction

目的观察急诊重组组织型纤溶酶原激活剂(rt-PA)动脉溶栓联合丹红注射液治疗急性脑梗死的临床效果。方法将40例患者按随机数字表法分为实验组和对照组,对照组单纯使用rt-PA动脉溶栓,实验组患者在进行rt-PA动脉溶栓治疗的基础上联合应用中药丹红注射液治疗,并对比分析其临床疗效。结果治疗前后两组神经功能缺损程度(NFDS)评分与Barthel评分比较,治疗后24 h、7 d、14 d两组评分与治疗前比较差异有统计学意义(P<0.05),且呈时间依赖性;两个治疗组相比较,NFDS评分在24 h及14 d时差异具有统计学意义(P<0.05),Barthel评分在14 d时差异具有统计学意义(P<0.05),且对照组患者治疗的显效率为60.00%,实验组患者治疗的显效率为75.00%;两组患者治疗后纤维蛋白质(FIB)、D-二聚体(D-Dimer)、部分活化凝血酶原时间(APTT)、凝血酶原时间(PT)指标差异均有统计学意义(P<0.05)。结论联合应用rt-PA动脉溶栓和丹红注射液治疗急性脑梗死患者可明显降低其发生出血性转化的风险,提高其临床疗效.

Objective: To investigate the efficacy and safety of intra-arterial thrombolysis with rt-PA and recombinant Dan red injection for the treatment of acute cerebral infarction. Methods: 40 ACI patients were selected and randomly divided into the experimental group and the control group,20 in each,and the two groups were given intraarterial thrombolysis with rt-PA,the experiment group joint Dan red injection after rt-PA intra-arterial thrombolysis,and analysis the clinical curative effect. All patients were assessed before treatment,24 hours,7 days and 14 days after the treatment according to NFDS and Barthel. Results: There were significant differences in NFDS and Barthel scores in both groups before treatment and 24 hours,10 days and 20 days after treatment in a time-dependent manner(P < 0.05). NFDS scores demonstrated significant differences at day 7 and day 14(P < 0.05);Barthel scores showed significant difference on day 14th(P < 0.05). The total effective rate of the experimental group was 75%,the total effective rate of the control group 60%. After the treatment,two groups of patients of FIB,D-Dimer,APTT and PT had significant indicators,with statistically significant(P < 0.05). Conclusion: Dan red injection combined with artery thrombolytic therapy of Acute cerebral artery can effectively reduce the risk of hemorrhagic transformation,and improve the final outcome of artery thrombolysis. It is worthy of wide use in treating acute cerebral infarction.