摘要
目的探讨丁苯酞联合重组人组织型纤溶酶原激活物[(rt-PA),阿替普酶]静脉溶栓治疗轻中度急性缺血性卒中(AIS)的临床疗效及安全性。方法176例符合rt-PA静脉溶栓标准的轻中度AIS患者,按照随机数字表法分为研究组与对照组,各88例。对照组给予阿替普酶静脉溶栓治疗,研究组在阿替普酶静脉溶栓后予以静脉滴注丁苯酞氯化钠注射液治疗。比较两组患者治疗后14 d的美国国立卫生研究院卒中量表(NIHSS)评分及症状性颅内出血发生情况、治疗后90 d的Barthel指数(BI)评分及死亡情况。结果研究组治疗后14 d NIHSS评分(4.74±3.66)分低于对照组的(6.59±3.85)分,治疗后90 d BI评分(90.43±11.27)分高于对照组的(78.44±11.76)分,差异均有统计学意义(P<0.05)。两组治疗后14 d症状性颅内出血发生率和治疗后90 d死亡率比较,差异均无统计学意义(P>0.05)。结论丁苯酞联合rt-PA静脉溶栓治疗轻中度AIS能改善患者近期的神经功能缺损和远期的临床预后,同时不增加症状性颅内出血和死亡率。
Objective To discuss the clinical efficacy and safety of butylphthalide combined with recombinant tissue-type plasminogen activator(rt-PA)intravenous thrombolysis in the treatment of mild to moderate acute ischemic stroke(AIS).Methods A total of 176 patients with mild to moderate AIS who met rt-PA intravenous thrombolysis standards were divided into research group and control group according to the random numerical table,with 88 cases in each group.The control group was treated with intravenous thrombolysis with alteplase after admission,and the research group was also treated with intravenous infusion of butylphthalide and sodium chloride injection after intravenous thrombolysis with alteplase.The National Institutes of Health stroke scale(NIHSS)score and occurrence of symptomatic intracranial hemorrhage at 14 d after treatment,the Barthel index(BI)score and mortality at 90 d after treatment were compared between the two groups.Results The NIHSS score(4.74±3.66)points at 14 d after treatment of the research group was lower than(6.59±3.85)points of the control group,and BI score(90.43±11.27)points at 90 d after treatment was higher than(78.44±11.76)points of the control group.All the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of symptomatic intracranial hemorrhage at 14 d after treatment and the mortality rate at 90 d after treatment between the two groups(P>0.05).Conclusion Intravenous thrombolysis with butylphthalide and rt-PA can improve the short-term neurological deficit and long-term clinical prognosis of patients with mild or moderate AIS,without increasing symptomatic intracranial hemorrhage and mortality.
作者
黄晓东
HUANG Xiao-dong(Shantou University Medical College,Shantou 515000,China)
出处
《中国现代药物应用》
2021年第15期1-4,共4页
Chinese Journal of Modern Drug Application
关键词
缺血性卒中
静脉溶栓
丁苯酞
阿替普酶
Ischemic stroke
Intravenous thrombolysis
Butylphthalide
Alteplase
