中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
34期
20-22
,共3页
血栓溶解疗法%尿激酶型纤溶酶原激活剂%组织型纤溶酶原激活物%卒中
血栓溶解療法%尿激酶型纖溶酶原激活劑%組織型纖溶酶原激活物%卒中
혈전용해요법%뇨격매형섬용매원격활제%조직형섬용매원격활물%졸중
Thrombolytic therapy%Urokinase-type plasminogen activator%Tissue plasminogen activator%Stroke
目的 比较尿激酶动脉溶栓与重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗缺血性卒中的临床疗效.方法 将100例缺血性卒中患者按照随机数字表法分为rt-PA静脉溶栓组和尿激酶动脉溶栓组,每组50例.观察并比较两组患者溶栓后血管再通率、病死率、并发症等.结果 rt-PA静脉溶栓组溶栓后血管再通率明显高于尿激酶动脉溶栓组[88.0％ (44/50)比66.0％(33/50)],并发症发生率明显低于尿激酶动脉溶栓组[6.0％ (3/50)比28.0％(14/50)],差异有统计学意义(P＜0.05).两组病死率比较差异无统计学意义(P＞0.05).两组溶栓前美国国立卫生研究院卒中量表(NIHSS)评分比较差异无统计学意义(P＞0.05);两组溶栓后1,3,10,30 d的NIHSS评分较溶栓前明显降低,差异有统计学意义(P＜0.05).两组不同时间NIHSS评分、溶栓后30 d改良Rankin 量表评分比较差异无统计学意义(P＞0.05).结论 rt-PA在缺血性卒中患者中的疗效明显优于尿激酶动脉溶栓治疗,不仅血管再通率高,且溶栓后并发症较少,安全有效,可作为缺血性卒中溶栓治疗的首选.
目的 比較尿激酶動脈溶栓與重組組織型纖溶酶原激活劑(rt-PA)靜脈溶栓治療缺血性卒中的臨床療效.方法 將100例缺血性卒中患者按照隨機數字錶法分為rt-PA靜脈溶栓組和尿激酶動脈溶栓組,每組50例.觀察併比較兩組患者溶栓後血管再通率、病死率、併髮癥等.結果 rt-PA靜脈溶栓組溶栓後血管再通率明顯高于尿激酶動脈溶栓組[88.0％ (44/50)比66.0％(33/50)],併髮癥髮生率明顯低于尿激酶動脈溶栓組[6.0％ (3/50)比28.0％(14/50)],差異有統計學意義(P＜0.05).兩組病死率比較差異無統計學意義(P＞0.05).兩組溶栓前美國國立衛生研究院卒中量錶(NIHSS)評分比較差異無統計學意義(P＞0.05);兩組溶栓後1,3,10,30 d的NIHSS評分較溶栓前明顯降低,差異有統計學意義(P＜0.05).兩組不同時間NIHSS評分、溶栓後30 d改良Rankin 量錶評分比較差異無統計學意義(P＞0.05).結論 rt-PA在缺血性卒中患者中的療效明顯優于尿激酶動脈溶栓治療,不僅血管再通率高,且溶栓後併髮癥較少,安全有效,可作為缺血性卒中溶栓治療的首選.
목적 비교뇨격매동맥용전여중조조직형섬용매원격활제(rt-PA)정맥용전치료결혈성졸중적림상료효.방법 장100례결혈성졸중환자안조수궤수자표법분위rt-PA정맥용전조화뇨격매동맥용전조,매조50례.관찰병비교량조환자용전후혈관재통솔、병사솔、병발증등.결과 rt-PA정맥용전조용전후혈관재통솔명현고우뇨격매동맥용전조[88.0％ (44/50)비66.0％(33/50)],병발증발생솔명현저우뇨격매동맥용전조[6.0％ (3/50)비28.0％(14/50)],차이유통계학의의(P＜0.05).량조병사솔비교차이무통계학의의(P＞0.05).량조용전전미국국립위생연구원졸중량표(NIHSS)평분비교차이무통계학의의(P＞0.05);량조용전후1,3,10,30 d적NIHSS평분교용전전명현강저,차이유통계학의의(P＜0.05).량조불동시간NIHSS평분、용전후30 d개량Rankin 량표평분비교차이무통계학의의(P＞0.05).결론 rt-PA재결혈성졸중환자중적료효명현우우뇨격매동맥용전치료,불부혈관재통솔고,차용전후병발증교소,안전유효,가작위결혈성졸중용전치료적수선.
Objective To compare the effect of arterial thombolysis with urokinase and intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA) in treatment of ischemic stroke.Methods One hundred patients with ischemic stroke were divided into intravenous thrombolysis (with rt-PA) group and arterial thrombolysis (with urokinase) group with 50 cases each by random digits table method.The thrombolytic recanalization rate,mortality rate and complications after treatment were observed and compared between two groups.Results The thrombolytic recanalization rate in intravenous thrombolysis (with rt-PA) group was higher than that in arterial thrombolysis (with urokinase) group [88.0％ (44/50) vs.66.0％ (33/50)],the complication rate in intravenous thrombolysis (with rt-PA) group was lower than that in arterial thrombolysis (with urokinase) group [6.0％ (3/50) vs.28.0％ (14/50)],and there was significant difference (P ＜ 0.05).There was no significant difference in mortality between two groups (P ＞ 0.05).There was no significant difference in the National Institutes of Health Stroke Scale (NIHSS) scores before treatment between two groups (P ＞ 0.05).The NIHSS scores 1,3,10,30 d after treatment were lower than those before treatment in two groups,and there were significant differences (P ＜ 0.05).There was no significant difference in NIHSS scores at different times and modified Rankin Scale 30 d after treatment between two groups (P＞ 0.05).Conclusions The efficacy of rt-PA in ischemic stroke patients is significantly better than that of the arterial thrombolysis with urokinase,with higher recanalization rate and fewer complications.It is safe and effective,and can be as the first choice for the treatment of ischemic stroke thrombolysis.
