非标准剂量阿替普酶静脉溶栓治疗急性缺血性卒中

发布时间：2018-02-28 20:53

本文关键词： 急性缺血性卒中静脉溶栓阿替普酶剂量　出处：《中风与神经疾病杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的比较分析非标准剂量与标准剂量阿替普酶静脉溶栓治疗急性缺血性卒中的有效性和安全性的差异。方法连续纳入北京大学深圳医院自2007年初-2015年底进行阿替普酶静脉溶栓治疗的急性缺血性卒中患者。根据阿替普酶使用剂量,分为非标准剂量组(0.521~0.833 mg/kg)和标准剂量组(0.9 mg/kg),比较分析两剂量组溶栓24 h后颅内出血率、死亡率及90 d mRS评分情况。结果溶栓前mRS评分均为0分,其中非标准剂量组48例(0.521~0.833 mg/kg,中位数为0.7245 mg/kg);标准剂量组51例(0.9 mg/kg)。两剂量组溶栓前NIHSS评分中位数均为13分,发病到溶栓时间的均值分别为200.75 min和197.53 min。校正基线变量差异后,两组症状性颅内出血率(8.33%vs 5.88%,P=0.727),死亡率(6.25%vs 9.8%,P=0.796),90 d患者生活自理比例(64.58%vs 64.71%,P=0.641)及获得良好预后比例(56.25%vs 49.02%,P=0.645)之间的差异均无统计学意义。结论非标准剂量阿替普酶静脉溶栓具有与标准剂量相同的有效性及安全性。对于中国人群,阿替普酶最佳剂量可能处于0.6~0.9 mg/kg之间。
[Abstract]:Objective to compare the efficacy and safety of intravenous thrombolytic therapy with non-standard dose and standard dose of atropine in patients with acute ischemic stroke. Methods from early 2007 to the end of 2015, the patients were admitted to Peking University Shenzhen Hospital. Patients with acute ischemic stroke treated with intravenous thrombolytic therapy. The patients were divided into non-standard dose group (0.521 ~ 0.833 mg / kg) and standard dose group (0.9 mg 路kg ~ (-1)). The intracranial hemorrhage rate, mortality rate and 90 day mRS score were compared and analyzed in two dose groups. Results the mRS score before thrombolysis was 0. In the non-standard dose group, 48 cases (0.521 ~ 0.833 mg / kg, median 0.7245 mg 路kg ~ (-1)), 51 cases of standard dose group (51 cases) with 0.9 mg 路kg ~ (-1) 路kg ~ (-1), the median NIHSS score before thrombolysis was 13 points, the mean time from onset to thrombolysis was 200.75 min and 197.53 min. after adjusting for the difference of baseline variables, There was no significant difference in the rate of symptomatic intracranial hemorrhage between the two groups (8.33 vs 5.88P0.727g, mortality 6.25 vs 9.896 / 90) and the ratio of self-care for 90 days (64.58 vs 64.71p 0.641) and the ratio of good prognosis (56.25 vs 49.02P0.645). Standard dose of the same efficacy and safety. For Chinese population, The optimum dose of atropase may be between 0. 6 and 0. 9 mg/kg.
【作者单位】：北京大学深圳医院神经内科;广州医科大学;
【基金】：深圳市战略新兴产业发展专项资金(No.JCYJ20150605103420338)
【分类号】：R743.3

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