摘要
目的 观察丁苯酞序贯疗法联合注射用阿替普酶（注射用重组人组织纤维蛋白溶酶原激活剂）治疗急性脑梗死临床疗效.方法 选取发病时间≤4.5 h的急性脑梗死患者61例为研究对象,利用随机数字表法将符合入选条件的患者分为观察组（丁苯酞联合阿替普酶组,31例）和对照组（阿替普酶组,30例）.两组在急性期均给予降糖、他汀类药物、维持血压、24 h后复查头颅CT如无出血则均加用阿司匹林肠溶片或氯吡格雷片.观察组先予注射用阿替普酶,后予丁苯酞序贯疗法;对照组只给予注射用阿替普酶,比较两组的美国国立卫生院神经功能缺损评分（NIHSS评分）和日常生活活动能力量表评分（BI指数）.结果 在治疗后24h、14 d和3.5个月,对照组和观察组的NIHSS评分均值比较差异有统计学意义（t=-0.102、-1.964和-2.444,P=0.037、0.018和0.012）.观察组的NIHSS评分比对照组分别降低2％、27％和41％.对照组和观察组在治疗后3.5个月的BI评分差异有统计学意义（t=-1.956,P=0.029）.结论 丁苯酞序贯疗法联合注射用阿替普酶对于发病4.5h的急性脑梗死患者具有良好的协同作用,是治疗发病4.5h急性脑梗死患者的一种安全有效的治疗方法,值得临床推广应用.
Objective To observe the effect of butylphthalide sequential therapy combined with injection of alteplase（injection with recombinant human collagenous tissue plasminogen activator） in the treatment of acute cerebral infarction （ACI）.Methods 61 patients with ACI and within 4.5 hours of onset were selected,and they were divided into treatment group（butylphthalide combined with alteplase group,31 cases） and the control group （alteplase only group,30 cases） by random number table.The two groups were given glucose-lowering,statins for maintaining the blood pressure,as well as aspirin enteric tablets or clopidogrel for those without bleeding on the 24 hour review head CT in the acute phase.The treatment group was given alteplase for injection with sequential butylphthalide therapy （butylphthalide injection for 2 weeks followed by an oral administration of butylphthalide soft capsules for 3 months）,and the control group was given only alteplase for injection.The National Institute of Health stroke scale （NIHSS） and Barthel index （BI） were used for evaluating the final clinical efficacy.Results The NIHSS scores of the treatment group compared with the control group at 24 hour,14 days and 3.5 months after the treatment had statistically significant differences （t =-0.102,-1.964,-2.444,P =0.037,0.018 and 0.012）.The NIHSS scores of the treatment group had decreased 2%,27% and 41% compared with the control group at 24 hour,14 days and 3.5 months after the treatment,respectively.The BI score of the treatment group and control group at 3.5 months after treatment had statistically significant difference （t =-1.956,P =0.029）.Conclusion The sequential butylphthalide therapy combined with injection of alteplase has good synergistic effect for the patients with onset of ACI less than 4.5 hours,and it is a safe and effective treatment method for ACI within 4.5 h and it is worthy of clinical promotion.
出处
《中国基层医药》
CAS
2017年第8期1231-1234,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
脑梗死
急性
丁苯酞
阿替普酶
Cerebral infarction,acute
Butylphthalide
Alteplase
