解放军医药杂志
解放軍醫藥雜誌
해방군의약잡지
MEDICAL&PHARMACEUTICAL JOURNAL OF CHINESE PEOPLE'S LIBERATION ARMY
2014年
11期
79-81,88
,共4页
阿替普酶%急性脑梗死%剂量效应关系,药物%治疗结果
阿替普酶%急性腦梗死%劑量效應關繫,藥物%治療結果
아체보매%급성뇌경사%제량효응관계,약물%치료결과
Alteplase%Acute cerebral infarction%Dose-response relationship,drug%Treatment Outcome
目的：比较不同剂量阿替普酶治疗急性脑梗死的效果。方法选择2012年11月—2014年5月入住北京军区总医院263临床部神经内科的符合溶栓指征的急性脑梗死(起病在4.5 h内)患者46例,随机分为两组,低剂量组(n=23)予0.6 mg/kg的阿替普酶、标准剂量组(n=23)予0.9 mg/kg的阿替普酶静脉溶栓治疗。比较两组治疗前及治疗后1、3天美国国立卫生研究院卒中患者神经功能缺损评分量表( national institutes of health stroke, NIHSS)及格拉斯哥昏迷量表( Glasgow coma scale, GCS)评分；比较静脉溶栓治疗前及治疗后7、28、90天改良Rankin( MRS)评分；比较两组治疗后总有效率。结果与治疗前比较,两组治疗后1、3天GCS评分均显著增高(P<0．05),NIHSS评分显著降低(P<0．05),治疗后28、90天MRS评分显著降低(P<0．05)；治疗后同时间两组上述指标差异均无统计学意义(P>0．05)；两组疗效差异无统计学意义(P>0．05)。结论不同剂量阿替普酶静脉溶栓治疗急性脑梗死均可促进神经功能缺损早期恢复、改善预后、提高患者的生活质量,低剂量阿替普酶静脉溶栓疗效肯定,值得临床推广应用。
目的：比較不同劑量阿替普酶治療急性腦梗死的效果。方法選擇2012年11月—2014年5月入住北京軍區總醫院263臨床部神經內科的符閤溶栓指徵的急性腦梗死(起病在4.5 h內)患者46例,隨機分為兩組,低劑量組(n=23)予0.6 mg/kg的阿替普酶、標準劑量組(n=23)予0.9 mg/kg的阿替普酶靜脈溶栓治療。比較兩組治療前及治療後1、3天美國國立衛生研究院卒中患者神經功能缺損評分量錶( national institutes of health stroke, NIHSS)及格拉斯哥昏迷量錶( Glasgow coma scale, GCS)評分；比較靜脈溶栓治療前及治療後7、28、90天改良Rankin( MRS)評分；比較兩組治療後總有效率。結果與治療前比較,兩組治療後1、3天GCS評分均顯著增高(P<0．05),NIHSS評分顯著降低(P<0．05),治療後28、90天MRS評分顯著降低(P<0．05)；治療後同時間兩組上述指標差異均無統計學意義(P>0．05)；兩組療效差異無統計學意義(P>0．05)。結論不同劑量阿替普酶靜脈溶栓治療急性腦梗死均可促進神經功能缺損早期恢複、改善預後、提高患者的生活質量,低劑量阿替普酶靜脈溶栓療效肯定,值得臨床推廣應用。
목적：비교불동제량아체보매치료급성뇌경사적효과。방법선택2012년11월—2014년5월입주북경군구총의원263림상부신경내과적부합용전지정적급성뇌경사(기병재4.5 h내)환자46례,수궤분위량조,저제량조(n=23)여0.6 mg/kg적아체보매、표준제량조(n=23)여0.9 mg/kg적아체보매정맥용전치료。비교량조치료전급치료후1、3천미국국립위생연구원졸중환자신경공능결손평분량표( national institutes of health stroke, NIHSS)급격랍사가혼미량표( Glasgow coma scale, GCS)평분；비교정맥용전치료전급치료후7、28、90천개량Rankin( MRS)평분；비교량조치료후총유효솔。결과여치료전비교,량조치료후1、3천GCS평분균현저증고(P<0．05),NIHSS평분현저강저(P<0．05),치료후28、90천MRS평분현저강저(P<0．05)；치료후동시간량조상술지표차이균무통계학의의(P>0．05)；량조료효차이무통계학의의(P>0．05)。결론불동제량아체보매정맥용전치료급성뇌경사균가촉진신경공능결손조기회복、개선예후、제고환자적생활질량,저제량아체보매정맥용전료효긍정,치득림상추엄응용。
Objective To compare the effects of different doses of Alteplase in treatment of acute cerebral infarc-tion. Methods A total of 46 acute cerebral infarction patients, who were consistent with thrombolysis indications (onset within 4. 5 h), were randomly divided into low dose group (n=23) and standard dose group (n=23) during November 2012 and May 2014. The low dose group received 0. 6 mg/kg Alteplase, while standard dose group was treated with 0. 9 mg/kg Alteplase through intravenous thrombolysis. Scores of national institutes of health stroke ( NIHSS) and Glasgow coma scale (GCS) were compared in the two groups before and on 1st and 3rd d after treatment;the modified Rankin scale (MRS) scores were compared before and on 7th, 28th and 90th d after treatment;the total efficiency of the two groups was also compared before and after treatment. Results Compared with those before treatment, in the two groups GCS scores were significantly increased (P<0. 05), while NIHSS scores were significantly decreased on 1st and 3rd d after treatment (P<0. 05), and the MRS scores were significantly decreased on 28th and 90th d after treatment (P<0. 05);the differ-ences in the indexes at the same time after treatment between the two groups were not statistically significant (P>0. 05);the difference in curative effect between the two groups was not statistically significant (P>0. 05). Conclusion Differ-ent doses of Alteplase thrombolysis in treatment of acute cerebral infarction can help early recovery of neurologic impair-ment, improve prognosis and the quality of life of patients, and the low dose Alteplase by intravenous thrombolysis has good curative effect.
