BACKGROUND:The study aimed to compare the therapeutic effect of recombinant tissue plasminogen activator(rt-PA) on the onset of acute cerebral infarction(ACI) at different time points of the first 6 hours.METHODS:A re...BACKGROUND:The study aimed to compare the therapeutic effect of recombinant tissue plasminogen activator(rt-PA) on the onset of acute cerebral infarction(ACI) at different time points of the first 6 hours.METHODS:A retrospective analysis was conducted in 74 patients who received rt-PA thrombolysis treatment within 4.5 hours after ACI and another 15 patients who received rt-PA thrombolysis treatment between 4.5-6 hours after ACI.RESULTS:National Institute of Health Stroke Scale(NIHSS) scores were statistically decreased in both groups(P>0.05) at 24 hours and 7 days after ACI.There was no significant difference in modified ranking scores and mortality at 90 days after the treatment between the two groups(P>0.05).CONCLUSIONS:The therapeutic effect and mortality of rt-PA treatment in patients with ACI between 4.5-6 hours after the onset of the disease were similar to those in patients who received rtPA within 4.5 hours after the onset of this disease.Therefore,intravenous thrombolytic therapy for ACI within 4.5-6 hours after ACI was effective and safe.展开更多
基金supported by a grant from Shanghai Municipal Health Bureau(GWDTR201219)
文摘BACKGROUND:The study aimed to compare the therapeutic effect of recombinant tissue plasminogen activator(rt-PA) on the onset of acute cerebral infarction(ACI) at different time points of the first 6 hours.METHODS:A retrospective analysis was conducted in 74 patients who received rt-PA thrombolysis treatment within 4.5 hours after ACI and another 15 patients who received rt-PA thrombolysis treatment between 4.5-6 hours after ACI.RESULTS:National Institute of Health Stroke Scale(NIHSS) scores were statistically decreased in both groups(P>0.05) at 24 hours and 7 days after ACI.There was no significant difference in modified ranking scores and mortality at 90 days after the treatment between the two groups(P>0.05).CONCLUSIONS:The therapeutic effect and mortality of rt-PA treatment in patients with ACI between 4.5-6 hours after the onset of the disease were similar to those in patients who received rtPA within 4.5 hours after the onset of this disease.Therefore,intravenous thrombolytic therapy for ACI within 4.5-6 hours after ACI was effective and safe.
文摘目的 探究重组组织型纤溶酶原激活剂(Recombinant Tissue Plasminogen Activator,rt-PA)超早期静脉溶栓治疗急性脑梗死的疗效。方法 随机选取2021年1月—2024年1月江苏省邳州市中医院收治的80例急性脑梗死患者为研究对象,以随机数表法分为两组,研究组(40例)实施rt-PA超早期静脉溶栓治疗,对照组(40例)实施常规治疗。比较两组的美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Baethel指数、格拉斯哥昏迷评分法(Glasgow Coma Scale,GCS)评分及不良反应发生情况。结果治疗后,研究组的NIHSS评分低于对照组,GCS评分高于对照组,差异有统计学意义(P均<0.05)。治疗24 h和治疗14 d,研究组的Baethel指数高于对照组,差异有统计学意义(P均<0.05)。研究组的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论 使用rt-PA超早期静脉溶栓治疗急性脑梗死能够有效的提高患者的日常生活活动能力和昏迷指数,快速帮助患者溶解血栓,提高治疗的效果,使得患者脑血流快速恢复,减少脑水肿等不良反应的发生。
文摘目的探究血管内介入联合重组组织型纤溶酶原激活物(recombinant tissue plasminogen activator,r-TPA)动脉溶栓治疗对急性脑梗死(acute cerebral infarction,ACI)患者血管完全再通率及血管内皮生长因子(vascular endothelial growth factor,VEGF)、D-二聚体(D-Dimer,D-D)水平的影响。方法选取2019-06/2021-07月在作者医院收治的202例ACI患者,采用简单随机分组和随机数表法将纳入的ACI患者分为观察组(n=101例)和对照组(n=101例)。对照组接受r-TPA动脉溶栓治疗,观察组采用r-TPA动脉溶栓与血管内介入联合治疗,均持续治疗2周。比较两组治疗前后血管完全再通率,采用美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)和日常生活能力量表(activity of daily living scale,ADL)对两组神经功能损伤和生活质量进行评分,比较两组ACI患者治疗前后血清VEGF、单核细胞趋化蛋白1(monocyte chemoattractant protein 1,MCP-1)和白细胞介素6(interleukin 6,IL-6)水平变化。观察两组凝血指标的变化,包括D-D、纤维蛋白原(fibrinogen,FIB)和凝血酶原时间(prothrombin time,PT),并记录治疗过程中可能出现的不良反应情况。结果治疗后,观察组临床疗效和血管完全再通率较对照组明显升高(P<0.05)。观察组在治疗后NIHSS评分和ADL评分均优于对照组(P均<0.05)。治疗前两组血清VEGF、MCP-1和IL-1水平差异无统计学意义。治疗后,两组VEGF水平升高,IL-6和MCP-1水平均降低(P均<0.05)。治疗后,两组D-D水平均降低,且观察组低于对照组(P<0.05)。治疗后观察组出血不良事件较对照组明显改善(P<0.05)。结论血管内介入联合r-TPA动脉溶栓治疗ACI可提高血管完全再通率,调节VEGF、MCP-1、IL-6和D-D水平,有利于患者神经功能恢复。
