中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
24期
53-55
,共3页
重组组织型纤维酶原激活剂%静脉溶栓%急性缺血性脑卒中%糖尿病%疗效
重組組織型纖維酶原激活劑%靜脈溶栓%急性缺血性腦卒中%糖尿病%療效
중조조직형섬유매원격활제%정맥용전%급성결혈성뇌졸중%당뇨병%료효
rt-PA%Intravenous thrombolytic therapy%Acute cerebral infarction%Diabetes mellitus%Curative effect
目的：探讨重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中伴糖尿病患者的疗效。方法：选取本院2010年1月-2014年1月收治的发病4.5 h以内急性缺血性脑卒中患者198例，根据有无伴糖尿病分为糖尿病组（100例）和非糖尿病组（98例），两组均给予重组组织型纤溶酶原激活剂静脉溶栓治疗，采用rt-PA 0.9 mg/kg（最大剂量为90 mg），先1 min静脉注射10%剂量，剩余的90%剂量溶于100 mL生理盐水1 h内静脉滴注。记录两组溶栓前、溶栓后24 h、7 d的神经功能缺损评分（NIHSS）和21 d后日常生活能力量表Barthel Index量表评分。比较两组患者治疗的总有效率、并发症的发生率及死亡率。结果：溶栓前，两组NIHSS评分比较差异无统计学意义（P>0.05）；溶栓后24 h和7 d，非糖尿病组NIHSS评分明显低于糖尿病组，差异具有统计学意义（P<0.01）；溶栓后21 d，非糖尿病组恢复率明显高于糖尿病组，差异具有统计学意义（P<0.05）；非糖尿病组治疗的总有效率明显高于糖尿病组，差异具有统计学意义（P<0.05）；两组并发症发生率和死亡率比较差异无统计学意义（P>0.05）。结论：rt-PA静脉溶栓治疗急性缺血性脑卒中伴糖尿病患者取得一定的治疗效果，但糖尿病是影响急性缺血性脑卒中预后的因素，糖尿病并不增加rt-PA溶栓后继发性出血的可能性。
目的：探討重組組織型纖溶酶原激活劑靜脈溶栓治療急性缺血性腦卒中伴糖尿病患者的療效。方法：選取本院2010年1月-2014年1月收治的髮病4.5 h以內急性缺血性腦卒中患者198例，根據有無伴糖尿病分為糖尿病組（100例）和非糖尿病組（98例），兩組均給予重組組織型纖溶酶原激活劑靜脈溶栓治療，採用rt-PA 0.9 mg/kg（最大劑量為90 mg），先1 min靜脈註射10%劑量，剩餘的90%劑量溶于100 mL生理鹽水1 h內靜脈滴註。記錄兩組溶栓前、溶栓後24 h、7 d的神經功能缺損評分（NIHSS）和21 d後日常生活能力量錶Barthel Index量錶評分。比較兩組患者治療的總有效率、併髮癥的髮生率及死亡率。結果：溶栓前，兩組NIHSS評分比較差異無統計學意義（P>0.05）；溶栓後24 h和7 d，非糖尿病組NIHSS評分明顯低于糖尿病組，差異具有統計學意義（P<0.01）；溶栓後21 d，非糖尿病組恢複率明顯高于糖尿病組，差異具有統計學意義（P<0.05）；非糖尿病組治療的總有效率明顯高于糖尿病組，差異具有統計學意義（P<0.05）；兩組併髮癥髮生率和死亡率比較差異無統計學意義（P>0.05）。結論：rt-PA靜脈溶栓治療急性缺血性腦卒中伴糖尿病患者取得一定的治療效果，但糖尿病是影響急性缺血性腦卒中預後的因素，糖尿病併不增加rt-PA溶栓後繼髮性齣血的可能性。
목적：탐토중조조직형섬용매원격활제정맥용전치료급성결혈성뇌졸중반당뇨병환자적료효。방법：선취본원2010년1월-2014년1월수치적발병4.5 h이내급성결혈성뇌졸중환자198례，근거유무반당뇨병분위당뇨병조（100례）화비당뇨병조（98례），량조균급여중조조직형섬용매원격활제정맥용전치료，채용rt-PA 0.9 mg/kg（최대제량위90 mg），선1 min정맥주사10%제량，잉여적90%제량용우100 mL생리염수1 h내정맥적주。기록량조용전전、용전후24 h、7 d적신경공능결손평분（NIHSS）화21 d후일상생활능역량표Barthel Index량표평분。비교량조환자치료적총유효솔、병발증적발생솔급사망솔。결과：용전전，량조NIHSS평분비교차이무통계학의의（P>0.05）；용전후24 h화7 d，비당뇨병조NIHSS평분명현저우당뇨병조，차이구유통계학의의（P<0.01）；용전후21 d，비당뇨병조회복솔명현고우당뇨병조，차이구유통계학의의（P<0.05）；비당뇨병조치료적총유효솔명현고우당뇨병조，차이구유통계학의의（P<0.05）；량조병발증발생솔화사망솔비교차이무통계학의의（P>0.05）。결론：rt-PA정맥용전치료급성결혈성뇌졸중반당뇨병환자취득일정적치료효과，단당뇨병시영향급성결혈성뇌졸중예후적인소，당뇨병병불증가rt-PA용전후계발성출혈적가능성。
Objective:To explore the curative effect of intravenous thrombolytic therapy with recombinant tissue plasminogen activator on acute cerebral infarction with diabetes mellitus.Method:One hundred and ninty-eight patients undergoing acute cerebral infarction admitted to our hospital from January 2010 to January 2014 were chosen and divided into diabetes mellitus group(100 cases)and non-diabetes mellitus group(98 cases),which was based on whether the patients suffer from diabetes mellitus. Both groups were given rt-PA intravenous thrombolytic therapy. Scores of the national institutes of health stroke scale(NIHSS)were recorded pre-therapy,24 hours and 7 days post-therapy. Barthel Index scores were recorded 21 days after therapy. The total efficiency,occurrence of complication and death rate of the two groups were compared. Result:Before treatment,the NIHSS scores were no statistical significance between two groups(P>0.05);the NIHSS scores of non-diabetes mellitus group were significantly lower than those of diabetes mellitus group at 24 hours and 7 days post-therapy(P<0.01);the recovery rate of non-diabetes mellitus group were significantly higher than that of diabetes mellitus group 21 days after therapy (P<0.05);the total efficiency of non-diabetes mellitus group was significantly higher than diabetes mellitus group(P<0.05). And occurrence of complication and death rate of the two groups were no statistical significance between two groups(P>0.05). Conclusion:Diabetes mellitus can affect the curative effect of intravenous thrombolytic therapy with recombinant tissue plasminogen activator on acute cerebral infarction,and would not increase the possibility of recurrent hyphema post intravenous thrombolytic therapy.
