【摘要】 目的分析重组组织型纤溶酶原激活剂(rt-PA)治疗老年缺血性脑血管疾病患者的有效性及安全性。方法选取2015年1月—2016年1月承德医学院附属医院收治的老年缺血性脑血管疾病患者62例,按随机数字表法分为对照组与观察组,每组31例。对照组患者予以常规治疗,观察组患者在对照组基础上加用rt-PA治疗;两组患者均连续治疗2周。比较两组患者治疗前及治疗后1、2、4周美国国立卫生研究院卒中量表(NIHSS)评分、血液流变学指标(全血高切黏度、全血低切黏度、血浆黏度)、血流动力学指标〔收缩期峰值流速(PSV)、舒张末期流速(EDV)、搏动指数(PI)〕,不良反应/并发症发生情况。结果两组患者治疗前NIHSS评分比较,差异无统计学意义(P>0.05);治疗后1、2、4周观察组患者NIHSS评分优于对照组(P<0.05)。时间与方法在全血高切黏度、全血低切黏度、血浆黏度上存在交互作用(P<0.05);方法在全血高切黏度、全血低切黏度、血浆黏度上主效应显著(P<0.05);时间在全血高切黏度、全血低切黏度、血浆黏度上主效应显著(P<0.05);治疗后1、2、4周观察组患者全血高切黏度、全血低切黏度、血浆黏度低于对照组(P<0.05)。时间与方法在PSV、EDV、PI上存在交互作用(P<0.05);方法在PSV、EDV、PI上主效应显著(P<0.05);时间在PSV、EDV、PI上主效应显著(P<0.05);治疗后1、2、4周观察组患者PSV、EDV高于对照组,PI低于对照组(P<0.05)。两组患者不良反应/并发症发生率比较,差异无统计学意义(P>0.05)。结论 rt-PA治疗老年缺血性脑血管疾病患者的有效性较好,安全性较高,可有效改善患者临床症状。更多还原

【Abstract】 Objective To analyze the effectiveness and safety of recombinant tissue plasminogen activator( rt-PA) in treating elderly patients with ischemic cerebrovascular disease. Methods A total of 62 elderly patients with ischemic cerebrovascular disease were selected in the Affiliated Hospital of Chengde Medical College from January 2015 to January 2016,and they were divided into control group and observation group according to random number table,each of 31 cases. Patients of control group received conventional treatment after admission,while patients of observation group received extra rt-PA based on conventional treatment; both groups continuously treated for 2 weeks. NIHSS score,hemorheologic index( including whole high- shear blood viscosity, whole low- shear blood viscosity and plasma viscosity) and hemodynamic index 〔including peak systolic velocity( PSV),end diastolic velocity( EDV) and pulsatility index( PI) 〕 before treatment,after 1 week,2 weeks and 4 weeks of treatment,and incidence of adverse reactions / complications were compared between the two groups. Results No statistically significant differences of NIHSS score was found between the two groups( P > 0. 05); after 1 week,2 weeks and 4weeks of treatment,NIHSS score of observation group was statistically significantly better than that of control group,respectively( P < 0. 05). There was interaction between time and method in whole high- shear blood viscosity,whole low- shear blood viscosity and plasma viscosity( P < 0. 05); the main effects of time and method were significant in whole high- shear blood viscosity,whole low- shear blood viscosity and plasma viscosity( P < 0. 05); whole high- shear blood viscosity,whole low-shear blood viscosity and plasma viscosity of observation group were statistically significantly lower than those of control group after1 week,2 weeks and 4 weeks of treatment( P < 0. 05). There was interaction between time and method in PSV,EDV and PI( P < 0. 05); the main effects of time and method were significant in PSV,EDV and PI( P < 0. 05); after 1 week,2 weeks and 4 weeks of treatment,PSV and EDV of observation group were statistically significantly higher than those of control group,while PI of observation group was statistically significantly lower than that of control group, respectively( P < 0. 05). No statistically significant differences of incidence of adverse reactions was found between the two groups( P > 0. 05). Conclusion rt-PA has relatively good effectiveness and high safety in treating elderly patients with ischemic cerebrovascular disease,can effectively relieve the clinical symptoms.更多还原