阿替普酶注射剂治疗急性缺血性脑卒中的临床研究

发布时间：2019-04-10 06:40

【摘要】：目的观察不同剂量和溶栓时间的阿替普酶治疗急性缺血性脑卒中的临床疗效和安全性。方法将220例急性缺血性脑卒中患者随机分为A组90例、B组90例和C组40例。A组予以阿替普酶0.6 mg·kg~(-1),静脉滴注,溶栓时间30 min;B组予以阿替普酶0.6 mg·kg~(-1),静脉滴注,溶栓时间约60 min;C组予以阿替普酶0.9 mg·kg~(-1),静脉滴注,溶栓时间约60 min。溶栓治疗1 d后,所有患者均口服阿司匹林100 mg·d~(-1),qd,持续3个月。比较3组患者的美国国立卫生研究院卒中量表(NIHSS)评分和药物不良反应的发生情况。结果治疗后1 h,A、B、C组NIHSS评分分别为(7.11±0.83),(8.24±0.96),(8.32±1.38)分;治疗后1 d,A、B、C组NIHSS评分分别为(7.92±0.93),(8.92±1.03),(9.09±1.17)分;治疗后7 d,A、B、C组NIHSS评分分别为(6.63±0.77),(7.31±0.83),(7.36±0.88)分;治疗后30 d,A、B、C组NIHSS评分分别为(4.89±0.62),(5.62±0.76),(5.78±0.87)分;治疗后90 d,A、B、C组NIHSS评分分别为(3.53±0.58),(4.77±0.55),(4.69±0.61)分,A组与B、C组比较差异均有统计学意义(P0.05),但B组和C组比较差异均无统计学意义(P0.05)。治疗后90 d,A、B、C组的预后良好率分别为72.22%(65/90例),54.44%(49/90例),55.00%(22/40例),A组与B、C组比较差异均有统计学意义(P0.05),但B组和C组比较差异均无统计学意义(P0.05)。3组患者出现的药物不良反应以牙龈出血为主,A、B、C组的药物不良反应率分别为8.89%,12.22%,17.50%,差异均无统计学差异(P0.05)。结论阿替普酶0.6 mg·kg~(-1),溶栓时间30 min的方案治疗脑卒中的临床疗效显著,不仅不增加出血的风险,而且可以减轻患者的经济负担。
[Abstract]:Objective to observe the clinical efficacy and safety of different dosage and time of thrombolysis with ateptidase in the treatment of acute ischemic stroke. Methods 220 patients with acute ischemic stroke were randomly divided into three groups: group A (n = 90), group B (n = 90) and group C (n = 40). Patients in group A were treated with ateptidase 0.6 mg kg~ (- 1), intravenous drip, thrombolysis time for 30 min;. Group B was given ateptidase 0.6 mg kg~ (- 1), intravenous drip, thrombolysis time about 60 min;C, intravenous infusion of atteppase 0.9 mg kg~ (- 1), intravenous infusion, thrombolysis time about 60 min.. After one day of thrombolytic therapy, all patients were given aspirin 100 mg 路d ~ (- 1), qd, orally for 3 months. (NIHSS) scores and adverse drug reactions were compared among the three groups. Results the NIHSS scores of group A, B and C were (7.11 卤0.83), (8.24 卤0.96), (8.32 卤1.38) one hour after treatment. The NIHSS scores of group A, B and C were (7.92 卤0.93), (8.92 卤1.03), (9.09 卤1.17) on the 1st day after treatment. The NIHSS scores of group A, B and C were (6.63 卤0.77), (7.31 卤0.83), (7.36 卤0.88) on the 7th day after treatment. The NIHSS scores of group A, B and C were (4.89 卤0.62), (5.62 卤0.76), (5.78 卤0.87) 30 days after treatment. 90 days after treatment, the scores of NIHSS in group A, B and C were (3.53 卤0.58), (4.77 卤0.55), (4.69 卤0.61) respectively. There was significant difference between group A and group B and C (P0.05). But there was no significant difference between group B and group C (P0.05). On the 90th day after treatment, the good prognosis rates of A, B and C groups were 72.22% (65 / 90), 54.44% (49 / 90), 55.00% (22 / 40,), A and B, n = 40), respectively. There was significant difference between group C and group C (P0.05), but there was no significant difference between group B and group C (P0.05). The adverse drug reactions in group 3 were mainly gingival bleeding, A, B, The adverse drug reaction rates in group C were 8.89%, 12.22% and 17.50%, respectively. There was no significant difference between the two groups (P0.05). Conclusion Ateppase 0.6 mg kg~ (- 1), thrombolytic therapy for 30 min is effective in the treatment of stroke, which not only does not increase the risk of bleeding, but also lightens the economic burden of the patients.
【作者单位】：临沂市人民医院急诊科;
【基金】：国家医学教育发展中心医学研究课题基金资助项目(2010-34-03-022)
【分类号】：R743.3

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