心脑血管病防治
心腦血管病防治
심뇌혈관병방치
PREVENTION AND TREATMENT OF CARDIO-CEREBRAL-VASCULAR DISEASE
2014年
6期
468-469,473
,共3页
急性脑梗死%静脉溶栓%重组组织型纤溶酶原激活物
急性腦梗死%靜脈溶栓%重組組織型纖溶酶原激活物
급성뇌경사%정맥용전%중조조직형섬용매원격활물
Acute ischemic stroke%Intravenous thrombolysis%rt_PA
目的：探讨重组组织型纤溶酶原激活物（rt_PA ）静脉溶栓治疗急性脑梗死的临床疗效。方法69例发病在4.5小时内具有溶栓指征的急性脑梗死患者，其中观察组37例行rt_PA静脉溶栓，对照组32例行常规抗血小板治疗。以美国国立卫生院卒中量表（NIHSS）评分评定溶栓后临床疗效，以Barthel指数（BI）评分及改良Rankin量表（mRS）评分判断治疗后90d生活质量及预后。结果观察组治疗后2h、24h、7d NIHSS评分显著低于对照组[（9.23±3.51）vs （11.32±1.12），（6.72±2.31）vs （9.24±2.53），（4.23±2.12）vs （7.34±1.43）]，差异有统计学意义（ P＜0.05）；治疗后90天BI评分观察组显著高于对照组[（78.56±3.51）vs （61.30±4.13）]，差异有统计学意义（ P＜0.05）；治疗后90天mRS评分疗效良好率观察组显著高于对照组[67.56％（25／37）vs 34.38％（11／32）]，差异有统计学意义（ P＜0.01）。观察组24h脑出血率及死亡率高于对照组[16.21％（6／37）vs 9.37％（3／32）]，但差异无统计学意义（ P＞0.05）。结论时间窗内rt_PA静脉溶栓治疗急性脑梗死近、远期疗效均较常规抗血小板治疗显著。
目的：探討重組組織型纖溶酶原激活物（rt_PA ）靜脈溶栓治療急性腦梗死的臨床療效。方法69例髮病在4.5小時內具有溶栓指徵的急性腦梗死患者，其中觀察組37例行rt_PA靜脈溶栓，對照組32例行常規抗血小闆治療。以美國國立衛生院卒中量錶（NIHSS）評分評定溶栓後臨床療效，以Barthel指數（BI）評分及改良Rankin量錶（mRS）評分判斷治療後90d生活質量及預後。結果觀察組治療後2h、24h、7d NIHSS評分顯著低于對照組[（9.23±3.51）vs （11.32±1.12），（6.72±2.31）vs （9.24±2.53），（4.23±2.12）vs （7.34±1.43）]，差異有統計學意義（ P＜0.05）；治療後90天BI評分觀察組顯著高于對照組[（78.56±3.51）vs （61.30±4.13）]，差異有統計學意義（ P＜0.05）；治療後90天mRS評分療效良好率觀察組顯著高于對照組[67.56％（25／37）vs 34.38％（11／32）]，差異有統計學意義（ P＜0.01）。觀察組24h腦齣血率及死亡率高于對照組[16.21％（6／37）vs 9.37％（3／32）]，但差異無統計學意義（ P＞0.05）。結論時間窗內rt_PA靜脈溶栓治療急性腦梗死近、遠期療效均較常規抗血小闆治療顯著。
목적：탐토중조조직형섬용매원격활물（rt_PA ）정맥용전치료급성뇌경사적림상료효。방법69례발병재4.5소시내구유용전지정적급성뇌경사환자，기중관찰조37례행rt_PA정맥용전，대조조32례행상규항혈소판치료。이미국국립위생원졸중량표（NIHSS）평분평정용전후림상료효，이Barthel지수（BI）평분급개량Rankin량표（mRS）평분판단치료후90d생활질량급예후。결과관찰조치료후2h、24h、7d NIHSS평분현저저우대조조[（9.23±3.51）vs （11.32±1.12），（6.72±2.31）vs （9.24±2.53），（4.23±2.12）vs （7.34±1.43）]，차이유통계학의의（ P＜0.05）；치료후90천BI평분관찰조현저고우대조조[（78.56±3.51）vs （61.30±4.13）]，차이유통계학의의（ P＜0.05）；치료후90천mRS평분료효량호솔관찰조현저고우대조조[67.56％（25／37）vs 34.38％（11／32）]，차이유통계학의의（ P＜0.01）。관찰조24h뇌출혈솔급사망솔고우대조조[16.21％（6／37）vs 9.37％（3／32）]，단차이무통계학의의（ P＞0.05）。결론시간창내rt_PA정맥용전치료급성뇌경사근、원기료효균교상규항혈소판치료현저。
Objective To investigate the clinical effects of rt_PA intravenous thrombolysis therapy on acute ischemic stroke.Methods Since January to December in 2010 ,The Neurology Department of Huzhou center hospital received and cured 69 patients in 4.5 hours after the onset of acute ischemic stroke who have thrombolysis indication and sign the treatment consent form.The 37 cases in treat-ment group received rt_PA intravenous thrombolysis therapy ,while 32 cases in control group received routine antiplatelet therapy.The United States national institutes of health stroke scale (NIHSS ) was used to evaluate the clinical effects after thrombolysis.Barthel in-dex (BI) and Modified Rankin scale (mRS) were used to judge quality of life and prognosis after treatment for 90 days. Results NHISS scores of treatment group were significantly lower than the control group after treatment for 2h ,24h and 7d [(9.23 ± 3.51) versus (11.32 ± 1.12) ,(6.72 ± 2.31) versus (9.24 ± 2.53) ,(4.23 ± 2.12) versus (7.34 ± 1.43)] ,there were statistical signifi-cance differences ( P<0.05 );BI score of treatment group was significantly higher than control group after treatment for 90 days [(78.56 ± 3.51 ) versus (61.30 ± 4.13 )] ,there was a statistical significance difference ( P<0.05 );Good Effect rate of mRS score of treatment group was significantly higher than the control group after treatment for 90 days [67.56% (25/37) versus 34.38% (11/32)] ,there was a statistical significance difference ( P<0.05).Cerebral hemorrhage rate after 24h in treatment group was higher than the control group [16.21% (6/37 ) versus 9.37% (3/32 )] ,there were no statistical significance ( P>0.05 ).Conclusions The short and long term curative effects of rt_PA intravenous thrombolysis treatment within the time window on acute cerebral infarction are significantly better than conventional antiplatelet therapy ,but the risk of hemorrhage is higher.
