摘要
目的评价重组组织型纤溶酶原激活剂(rt-PA)动-静脉联合溶栓治疗急性脑梗死的疗效及安全性。方法选择符合入选标准的急性脑梗死患者48例,分为动-静脉联合溶栓组(溶栓组)24例和对照组24例。溶栓组先按0.6 mg/kg计算静脉rt PA用量,10%静脉推注,余量在60 min内滴完。随后行数字减影血管造影检查,血管闭塞者,酌情给予rt-PA 5～20 mg超选择接触性溶栓。对照组应用低分子右旋糖酐500 ml加复方丹参16 ml静脉滴注,1次/d,连用8 d。采用欧洲脑卒中神经缺损评分量表(ESS)、Barthel指数评价神经功能恢复状况。结果与对照组比较,溶栓组患者在溶栓后24 h、21 d ESS评分明显升高(P<0.05)。溶栓组(58.3%)明显高于对照组(25.0%)。结论小剂量rt-PA及时静脉溶栓,延长了治疗时间窗,联合动脉溶栓又提高了血管再通率,促进了临床预后的改善。
Objective To investigate the efficacy and safety of combined intravenous（IV） and local intra-arterial（IA） recombinant tissue plasminogen activator（rt-PA） in treatment of patients with acute ischemic stroke. Methods Forty-eight acute stroke patients consistent with the inclusion criteria were divided into the IV/IA thrombolysis group and control group. An IV dose of 0. 6 mg/kg rtPA was given,with 10% given as an initial bolus and the remainder given as a constant infusion over 60 minutes, rt-PA 5-20 mg was then given as IA administration in the IV/IA thrombolysis group;whereas the control group received only routine treatment. European Stroke Scale（ESS） and Barthel Index（BI） were used to evaluate the recovery of neurological functions. Results The efficacy in the IV/IA thrombolysis group was significantly higher than that in control group （P 〈.05）. Conclusion Combined treatment that uses immediate initiation of therapy with IV rt-PA to prolong the treatment time window and rapid local IA administration of rt-PA to improve recanalization efficacy may improve clinical outcome after acute ischemic stroke.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2010年第12期1108-1110,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
纤溶酶原激活剂
脑梗死
血栓溶解疗法
输注动脉内
输注静脉内
血管造影术
数字减影
治疗结果
plasminogen activators
brain infarction
t hrombolytic therapy
infusions, intra-arterial
infusions, intravenous
angiography, digital subtraction
treatment outcome
