摘要
目的探讨急性缺血性脑卒中患者阿替普酶(rt-PA)静脉溶栓治疗后出现口舌部血管性水肿(orolingual angioedema,OA)的相关因素,以提高rt-PA相关性口舌部血管性水肿的预测能力。方法回顾性分析2019-06—2020-08于天津市环湖医院神经内科四病区接受rt-PA静脉溶栓治疗的1218例急性缺血性脑卒中患者的资料,分析静脉溶栓治疗后发生口舌部血管性水肿的相关因素。结果共纳入1218例接受rt-PA静脉溶栓的急性缺血性脑卒中患者,其中13例(男5例,女8例)在应用rt-PA后出现OA,发病率为1.07%。13例患者中9例为静脉溶栓过程中发生OA,4例静脉溶栓后发生OA,其中10例表现为口唇水肿,8例表现广泛舌部肿胀,3例表现半侧舌部肿胀,2例合并呼吸窘迫。6例曾口服血管紧张素转换酶抑制剂(ACEI)类降压药。结论口舌部血管性水肿是rt-PA静脉溶栓治疗后少见的并发症,口服ACEI类降压药、既往过敏史可增加口舌部血管性水肿的风险。
Objective To investigate the related factors of orolingual angioedema(OA)in patients with acute ischemic stroke after the administration of intravenous thrombolytic therapy.Methods We recruited 1218 cases of patients with acute ischemic stroke that were treated in the Department of Neurology of the Tianjin Huanhu Hospital from June 2019 to August 2020.The clinical manifestations of rt-PA related OA were recorded,the related factors of OA after intravenous thrombolytic therapy were analyzed.Results Thirteen cases of patients developed OA,with a prevalence rate of 1.07%.Among them,nine developed OA in the process of intravenous thrombolysis and 4 after intravenous thrombolysis,ten showed lip edema,eight showed extensive swelling of tongue,three showed swelling of lateral tongue,two were complicated by respiratory distress,and six had previously been given oral ACEI drugs.Conclusion OA is a rare complication that occurs after rt-PA intravenous thrombolytic therapy,patients take ACEI drugs,have a history of allergies were the risks of OA after rt-PA intravenous thrombolytic therapy.
作者
李雨晴
张佩兰
LI Yuqing;ZHANG Peilan(Tianjin Huanhu Hospital,Tianjin 300350,China)
出处
《中国实用神经疾病杂志》
2021年第18期1617-1624,共8页
Chinese Journal of Practical Nervous Diseases
关键词
阿替普酶
急性缺血性脑卒中
口舌部血管性水肿
静脉溶栓
血管紧张素转化酶抑制剂
Recombinant tissue plasminogen activator
Acute ischemic stroke
Orolingual angioedema
Intravenous thrombolysis
Angiotensin converting enzyme inhibitor
