CAJ | 학술논문

目的：探讨低分子肝素钙对急性脑梗死阿替普酶静脉溶栓后血管再闭塞患者的应用价值。方法收集2010－2014年上海市同仁医院神经内科收治的经阿替普酶静脉溶栓后血管再闭塞的44例急性脑梗死患者资料，根据是否采用低分子肝素钙，分为抗凝组和对照组，抗凝组23例，对照组21例。评价两组治疗后1、14、90 d的疗效，包括神经功能缺损评分（ NIHSS）及mRS评分，同时观察90 d内再脑出血发生率及病死率。结果抗凝组和对照组14 d总有效率分别为78．3％、42．9％，差异有统计学意义（P＜0．05）；90 d mRS评分分别为2．00±1．51、3．10±1．76，差异有统计学意义（P＜0．05）。抗凝组和对照组脑出血（症状性脑出血＋非症状性脑出血）发生率分别为17．4％、14．3％，病死率分别为8．7％、9．5％，两组比较，差异均无统计学意义。结论低分子肝素钙治疗阿替普酶溶栓后血管再闭塞，可改善患者神经功能，效果满意。
목적：탐토저분자간소개대급성뇌경사아체보매정맥용전후혈관재폐새환자적응용개치。방법수집2010－2014년상해시동인의원신경내과수치적경아체보매정맥용전후혈관재폐새적44례급성뇌경사환자자료，근거시부채용저분자간소개，분위항응조화대조조，항응조23례，대조조21례。평개량조치료후1、14、90 d적료효，포괄신경공능결손평분（ NIHSS）급mRS평분，동시관찰90 d내재뇌출혈발생솔급병사솔。결과항응조화대조조14 d총유효솔분별위78．3％、42．9％，차이유통계학의의（P＜0．05）；90 d mRS평분분별위2．00±1．51、3．10±1．76，차이유통계학의의（P＜0．05）。항응조화대조조뇌출혈（증상성뇌출혈＋비증상성뇌출혈）발생솔분별위17．4％、14．3％，병사솔분별위8．7％、9．5％，량조비교，차이균무통계학의의。결론저분자간소개치료아체보매용전후혈관재폐새，가개선환자신경공능，효과만의。
Objective To study application value of the low molecular weight heparin calcium in re-occlusion patients in the process of thrombolysis with alteplase.Methods Forty-four patients with acute cerebral infarction admitted into this hospital in 2010-2014 were divided into observation group(n=23) and control groups(n=21).The former received low molecular weight heparin calci-um combined with alteplase.The outcome scores were evaluated according to the National Institute of Heath Stroke Scale( NIHSS) be-fore treatment and 1 d, 14 d after thrombolysis,the modified Rankin Scale ( mRS) score after thrombolysis 90 d were observed,and the mortality, hemorrhagic transformation as the safety indicators were evaluated.Results There were significant differences in efficacy outcome rate (78.3%, 42.9%, respectively) between the two groups at 14 days (P<0.05).There were no significant differences between the two groups in the incidence of mortality and cerebral hemorrhage ( symptomatic and non-symptomatic intracerebral hemor-rhage) at 90 d.There were significant differences between the two groups at 90 d in mRS score (2.00 ±1.51, 3.10 ±1.76, respec-tively,P<0.05).Conclusions The treatment of the low molecular weight heparin calcium combined with alteplase in patients with aggravation of signs and symptoms in the process of thrombolysis can improve neurological function with satisfactory results.