【摘要】 目的:探讨急性脑梗死患者静脉溶栓使用小剂量(0.6 mg/kg)阿替普酶的临床疗效及安全性。方法:将2016年1月至2019年12月我院神经内科收治的溶栓时间窗内40例急性脑梗死患者随机分为标准剂量组(0.9 mg/kg)和小剂量组(0.6 mg/kg),每组20例,分别在溶栓前、溶栓后1小时对患者进行美国国立卫生研究院卒中量表(NIHSS)评分,溶栓前和溶栓后24小时做头颅CT排除脑出血,密切监测不良反应。结果:标准剂量组有效率为80.00%,小剂量组有效率为75.00%,两组比较差异无统计学意义(P>0.05)。治疗前两组NIHSS评分比较差异无统计学意义(P>0.05),治疗后两组NIHSS评分均降低,与治疗前相比差异有统计学意义(P<0.05),治疗后两组NIHSS评分差异无统计学意义(P>0.05)。标准剂量组总不良反应发生率为40.00%,高于小剂量组的20.00%,差异无统计学意义(P>0.05)。结论:阿替普酶可有效改善急性脑梗死患者的神经功能,小剂量(0.6 mg/kg)与标准剂量(0.9 mg/kg)溶栓效果相当,安全性较好,出血事件发生率较低,可根据患者情况酌情选用小剂量。更多还原

【Abstract】 Objective: To investigate the clinical efficacy and safety of low-dose(0.6 mg/kg) alteplase in patients with acute cerebral infarction. Methods: 40 acute cerebral infarctionpatients within thrombolysis time window admitted in neurology department of our hospital from January 2016 to December 2019 were randomly divided into standard dose group(0.9 mg/kg) and small dose group(0.6 mg/kg), there were 20 cases in each group. National Institutes of Health Stroke Scale(NIHSS) scores were assessed before and 1 hour after thrombolysis. CT scan was performed before and 24 hours after thrombolysis to exclude cerebral hemorrhage and close monitor of adverse reactions. Results: The effective rate was 80.00% in standard dose group and 75.00% in small dose group, there was no significant difference between the two groups(P>0.05). There was no significant difference in NIHSS scores between the two groups before treatment(P >0.05). NIHSS scores in both groups were decreased after treatment, the difference was statistically significant compared with before treatment(P<0.05). There was no significant difference in NIHSS score between the two groups after treatment(P>0.05). The total incidence of adverse reactions was 40.00% in the standard dose group, which was higher than 20.00% in the small dose group,the difference was no statistically significant(P >0.05). Conclusion: Alteplase can effectively improve the neurological function of patients with acute cerebral infarction. The thrombolytic effect of low dose(0.6 mg/kg) is similar to that of standard dose(0.9 mg/kg), the safety is good and the incidence of bleeding is low.Small dose can be selected according to the patient’s condition.更多还原