中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
2期
76-79
,共4页
李莹%陈辉%刘楠%黄勇华
李瑩%陳輝%劉楠%黃勇華
리형%진휘%류남%황용화
急性脑梗死%静脉溶栓%重组人组织纤溶酶原激活物%尿激酶%时间窗
急性腦梗死%靜脈溶栓%重組人組織纖溶酶原激活物%尿激酶%時間窗
급성뇌경사%정맥용전%중조인조직섬용매원격활물%뇨격매%시간창
Acute cerebral infarction%Thrombolysis%Recombinant tissue plasminogen%Urokinase%Time window
目的:探讨重组人组织纤溶酶原激活物(rtPA)联合尿激酶静脉溶栓治疗发病6 h内的急性脑梗死的有效性及安全性。方法回顾性收集本院2005年11月~2012年12月所有接受静脉溶栓治疗的患者,共纳入129例患者,根据用药史分为rtPA组(63例)及rtPA联合尿激酶组(66例),记录患者的一般临床资料及发病到用药时间;基线及用药7、30、90 d的美国国立卫生院卒中评分(NIHSS)、Barthel指数(BI);溶栓后的出血率及死亡率。结果两组患者静脉溶栓后各随访时间点NIHSS及BI均较治疗前改善,差异有统计学意义(P<0.05);随访90 d,rtPA组与rtPA加尿激酶组相比,NIHSS改善略明显,但两组间差异无统计学意义(P>0.05)。两组间在安全性和有效性上差异无统计学意义(P>0.05)。结论发病6 h内无禁忌证的急性脑梗死患者rtPA联合尿激酶静脉溶栓的疗效和安全性与rtPA静脉溶栓无显著性差异。
目的:探討重組人組織纖溶酶原激活物(rtPA)聯閤尿激酶靜脈溶栓治療髮病6 h內的急性腦梗死的有效性及安全性。方法迴顧性收集本院2005年11月~2012年12月所有接受靜脈溶栓治療的患者,共納入129例患者,根據用藥史分為rtPA組(63例)及rtPA聯閤尿激酶組(66例),記錄患者的一般臨床資料及髮病到用藥時間;基線及用藥7、30、90 d的美國國立衛生院卒中評分(NIHSS)、Barthel指數(BI);溶栓後的齣血率及死亡率。結果兩組患者靜脈溶栓後各隨訪時間點NIHSS及BI均較治療前改善,差異有統計學意義(P<0.05);隨訪90 d,rtPA組與rtPA加尿激酶組相比,NIHSS改善略明顯,但兩組間差異無統計學意義(P>0.05)。兩組間在安全性和有效性上差異無統計學意義(P>0.05)。結論髮病6 h內無禁忌證的急性腦梗死患者rtPA聯閤尿激酶靜脈溶栓的療效和安全性與rtPA靜脈溶栓無顯著性差異。
목적:탐토중조인조직섬용매원격활물(rtPA)연합뇨격매정맥용전치료발병6 h내적급성뇌경사적유효성급안전성。방법회고성수집본원2005년11월~2012년12월소유접수정맥용전치료적환자,공납입129례환자,근거용약사분위rtPA조(63례)급rtPA연합뇨격매조(66례),기록환자적일반림상자료급발병도용약시간;기선급용약7、30、90 d적미국국립위생원졸중평분(NIHSS)、Barthel지수(BI);용전후적출혈솔급사망솔。결과량조환자정맥용전후각수방시간점NIHSS급BI균교치료전개선,차이유통계학의의(P<0.05);수방90 d,rtPA조여rtPA가뇨격매조상비,NIHSS개선략명현,단량조간차이무통계학의의(P>0.05)。량조간재안전성화유효성상차이무통계학의의(P>0.05)。결론발병6 h내무금기증적급성뇌경사환자rtPA연합뇨격매정맥용전적료효화안전성여rtPA정맥용전무현저성차이。
Objective To investigate the effect and safety of recombinant tissue plasminogen (rtPA) combined with urokinaseon in treatment of acute cerebral infarction. Methods 129 patients who received thrombolytic therapy in our hospital from November 2005 to December 2012 were selected,and were divided into rtPA group (63 cases) and rtPA combined with urokinaseon group (66 cases).The demographic data,onset-to-needle time and baseline clinical charac-teristics (symptoms,medical history,blood pressure,blood glucose,blood lipids,National Institutes of Health Stroke Scale (NIHSS) score,Barthel index (BI) were recorded at baseline.The NIHSS and BI were recorded at 7 days,30 days and 90 days after thrombolysis.The mortality rate and theincidences of intracerebral and other hemorrhages were recorded. Re-sults After intravenous thrombolysis each follow-up time point,NIHSS and BI of two groups was improved than that be-fore treatment,the difference was significant (P<0.05);Follow-up for 90 days,the improvement of NIHSS in rtPA group was better than that of rtPA combined with urokinase group,but there was no significant difference (P>0.05).There was no significant difference on the safety and efficacy between the two groups (P>0.05). Conclusion For patients with acute cerebral infarction and no contraindications onset within 6 hours,the efficacy and safety of rtPA combined with uroki-nase is similar to urokinase thrombolytic.