CAJ | 학술논문

目的：评价急性脑梗死（Acute cerebral infarction，ACI）患者应用阿替普酶静脉溶栓治疗的有效性与安全性。方法回顾分析2010年5月至2013年5月78例ACI溶栓治疗的患者临床资料，并选取同期未予溶栓治疗的ACI患者80例为对照组，应用美国国立卫生研究院卒中量表（NHISS评分）和改良Rankin量表（mRS评分）评价两组的神经功能改善程度和近期预后。结果溶栓组治疗后24h NIHSS评分（7.68±4.62），mRS评分(3.28±0.41)，治疗后7d的NIHSS评分(5.25±4.43)，mRS评分(1.11±0.62)，两组相比差异具有统计学意义（P＜0.01）。溶栓组患者齿龈出血58例（74%），7d无症状性出血性转化14例（18%），症状性颅内血肿3例（4%），死亡4例（5%）。非溶栓组齿龈出血2例（3%），7d无症状性出血性转化5例（6%），症状性颅内血肿2例(3%)，死亡3例(4%)。结论在ACI治疗时间窗内，阿替普酶静脉溶栓治疗，可以减轻患者的神经功能障碍评分，不增加病死率，有效安全。
목적：평개급성뇌경사（Acute cerebral infarction，ACI）환자응용아체보매정맥용전치료적유효성여안전성。방법회고분석2010년5월지2013년5월78례ACI용전치료적환자림상자료，병선취동기미여용전치료적ACI환자80례위대조조，응용미국국립위생연구원졸중량표（NHISS평분）화개량Rankin량표（mRS평분）평개량조적신경공능개선정도화근기예후。결과용전조치료후24h NIHSS평분（7.68±4.62），mRS평분(3.28±0.41)，치료후7d적NIHSS평분(5.25±4.43)，mRS평분(1.11±0.62)，량조상비차이구유통계학의의（P＜0.01）。용전조환자치간출혈58례（74%），7d무증상성출혈성전화14례（18%），증상성로내혈종3례（4%），사망4례（5%）。비용전조치간출혈2례（3%），7d무증상성출혈성전화5례（6%），증상성로내혈종2례(3%)，사망3례(4%)。결론재ACI치료시간창내，아체보매정맥용전치료，가이감경환자적신경공능장애평분，불증가병사솔，유효안전。
Objective To explore the efficacy and safety of intravenous thrombolysis with alteplase patients with acute ischemic stroke. Methods Clinical data of 78 patients with acute ischemic stroke (AIS) receiving thrombolytic therapy with alteplase and 80 AIS patients without receiving thrombolytic therapy were retrospectively analyzed.The U.S. National Institutes of Health Stroke Scale (NHISS) and modified Rankin Scale (mRS) were used to identify the extent of neurological function improvement and prognosis of patients at 24h and 7 days after thrombolysis. Results In the group with intravenous thrombolysis, the significant difference in NIHSS was found between 24th hour and 7th day (7.69±4.63) vs (5.25±4.43), P<0.05, but in the control group, the decreased NIHSS scores and mRS scores (1.11±0.62) vs (3.22±0.80) both shown significant differences between intravenous thrombolysis group and controls. Among the intravenous thrombolysis group, there were 58 (74%) bleeding gums, 14 (18%) hemorrhagic transformation, 3 (4%) symptomatic intracerebral hemorrhage, and 4 (5%) patients died. In the control group, 2 (3%) had bleeding gums, 5 (6%) intracerebral hemorrhage, 2 (3%) symptomatic intracerebral hemorrhage, and 3 (4%) patients died. Conclusion This study suggests that intravenous rtPA treatment was safe and effective in patients with AIS.