摘要
目的通过对比不同剂量的阿替普酶溶栓治疗急性缺血性脑卒中的效果,分析阿替普酶的最佳剂量,为临床医师选择合理用药方案提供参考。方法选取本院2017年1月至2018年6月收治急性缺血性脑卒中且符合静脉溶栓指征的患者100例作为本次研究对象。随机将患者分成两组,各50例。A组予以标准计量阿替普酶(0.9mg/kg)静脉溶栓治疗,B组予以低剂量阿替普酶(0.6mg/kg)静脉溶栓治疗,对比两组患者治疗前后NIHSS评分情况,随访3个月评估预后情况,对比两组患者的治疗疗效与病死率的组间差异。结果经治疗后,两组患者的NIHSS评分均有显著改善(P<0.05),NIHSS评分、总有效率、颅内出血发生几率以及90d病死率的组间对比差异无统计学意义;而A组患者90d预后良好率对比B组显著更高(P<0.05)。结论对于急性缺血性脑卒中的治疗中,应用0.9mg/kg标准剂量的阿替普酶进行静脉溶栓治疗具更好的预后效果,该剂量治疗后患者未增加SICH的风险,0.9mg/kg标准剂量值得在临床上进行推广与应用。
Objective To compare the effects of different doses of alteplase in thrombolytic therapy for acute ischemic stroke, and to analyze the optimal dosage of alteplase, to provide references for clinicians in choosing rational drug regimens. Methods From January 2017 to June 2018, 100 patients with acute ischemic stroke who met the indications of intravenous thrombolysis were selected as the subjects of this study. The patients were randomly divided into two groups, 50 cases in each group. Group A received standard dosage of alteplase (0.9 mg/kg) intravenous thrombolytic therapy, and group B received low dose of alteplase (0.6 mg/kg) intravenous thrombolytic therapy. The NIHSS scores of the two groups before and after treatment were compared, and the prognosis was evaluated after 3 months' follow-up. The differences between the two groups in therapeutic efficacy and mortality were compared. Results After treatment, the NIHSS scores of the two groups were significantly improved (P<0.05). There was no significant difference in NIHSS scores, total effective rate, incidence of intracranial hemorrhage and mortality of 90 days between the two groups, while the 90-day good prognosis rate of group A was significantly higher than that of group B (P<0.05). Conclusion For the treatment of acute ischemic stroke, intravenous thrombolytic therapy with standard dose(0.9 mg/kg)of alteplase has better prognosis. The risk of SICH is not increased after treatment with this dose. The standard dose of 0.9 mg/kg is worth popularizing and applying in clinic.
作者
李凤进
郑晓红
徐立明
Li Fengjin;Zheng Xiaohong;Xu Liming(Department of Neurology, Lingyuan Central Hospital, Lingyuan, Liaoning, 122500, China)
出处
《当代医学》
2019年第16期82-84,共3页
Contemporary Medicine
关键词
阿替普酶
静脉溶栓
急性缺血性卒中
最佳剂量
对比分析
Alteplase
Intravenous thrombolysis
Acute ischemic stroke
Optimal dose
Comparative analysis
