【摘要】 目的观察急性脑梗死静脉溶栓应用不同剂量重组组织型纤溶酶原激活剂治疗的疗效及安全性。方法选取2016年6月至2018年4月本院脑病科诊治的80例急性脑梗死患者作为研究对象,按不同剂量方案分为两组,每组40例。观察组采用低剂量rt-PA(0.6 mg/kg)治疗,对照组常规剂量rt-PA(0.9 mg/kg)治疗,比较两组神经功能、临床疗效及预后。结果观察组和对照组治疗后NIHSS功能评分分别为(12.09±0.68)、(11.87±0.42)分,均比治疗前低,差异具有统计学意义(P<0.05),两组治疗后NIHSS评分相比差异无统计意义;两组治疗7 d的总有效率相比差异无统计意义;两组出血率相比差异无统计意义,对照组经6个月随访脑梗死复发率、死亡率比观察组低,差异具有统计学意义(P<0.05)。结论低剂量、常规剂量的重组组织型纤溶酶原激活剂在急性脑梗死静脉溶栓治疗中的疗效相当,均能改善神经功能,出血率无差异,但常规剂量能降低脑梗死复发率、死亡率,预后相对更佳。更多还原

【Abstract】 Objective To observe the efficacy and safety of intravenous thrombolysis for acute cerebral infarction with different doses of recombinant tissue plasminogen activator. Methods 80 patients with acute cerebral infarction who were diagnosed and treated in the department of encephalopathy of our hospital from June 2016 to April 2018 were selected as research objects. They were divided into two groups according to different dose regimens, with 40 cases in each group. The observation group was treated with low dose rt-PA(0.6 mg/kg), while the control group was treated with conventional rt-PA(0.9 mg/kg). Neurological function, clinical efficacy and prognosis of the two groups were compared. Results The NIHSS functional scores of the observation group and the control group were(12.09±0.68) and(11.87±0.42) points, respectively, lower than those before treatment, with statistically significant difference(P<0.05). There was no statistically significant difference in NIHSS scores between the two groups after treatment. There was no statistical difference in the total effective rate between the two groups after 7 days of treatment. There was no statistical difference in the bleeding rate between the two groups, and the recurrence rate and mortality rate of cerebral infarction in the control group after 6 months of follow-up were lower than those in the observation group, with statistically significant difference(P<0.05). Conclusion Low dose and routine dose of recombinant tissue plasminogen activator have similar efficacy in intravenous thrombolytic therapy of acute cerebral infarction, both of which can improve nerve function and have no difference in bleeding rate, but routine dose can reduce the recurrence rate and mortality rate of cerebral infarction and have better prognosis.更多还原