不同时间窗内rt-PA溶栓治疗VBA脑梗死的效果及预后

发布时间：2018-10-26 19:43

【摘要】：目的探究椎基底动脉系统(VBA)脑梗死患者在不同时间窗内重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗的疗效及预后情况分析。方法选取在该院进行rt-PA静脉溶栓治疗的71例VBA脑梗死患者,按照发病-溶栓治疗时间不同分为两组,将发病-溶栓治疗时间3.0 h内的35例患者作为观察组,另外发病-溶栓治疗时间在3.0 h~4.5 h之间的36例患者作为对照组。对比两组患者溶栓治疗效果及预后情况。结果两组患者在溶栓治疗前和治疗后7 d、15 d的NIHSS评分与Barthel指数无统计学意义(P0.05),仅在治疗后90 d时观察组NIHSS评分显著小于对照组,且Barthel指数显著大于对照组(P0.05);溶栓治疗7 d后,观察组患者总有效率为82.86%;对照组患者总有效率为75.00%,两组溶栓治疗7 d后疗效比较,差异无统计学意义(χ2=0.658,P=0.418);两组患者溶栓治疗7 d后脑出血率、mRS评分明显低于对照组(P0.05)。两组患者溶栓治疗后7 d病死率比较,差异无统计学意义(P0.05)。结论 VBA脑梗死患者rt-PA溶栓在时间窗3.0~4.5 h与时间窗3.0 h近期效果相似,死亡风险相当,但时间窗3.0 h患者可以降低脑出血的发生,远期疗效显著。
[Abstract]:Objective to investigate the effect and prognosis of thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with vertebrobasilar artery (VBA) cerebral infarction. Methods Seventy-one patients with rt-PA cerebral infarction who received intravenous thrombolytic therapy in our hospital were divided into two groups according to the time of pathogenic-thrombolytic therapy. 35 patients within 3.0 hours were selected as the observation group. Another 36 patients who had been treated with thrombolytic therapy for 3. 0 h or 4. 5 h were used as control group. The effect and prognosis of thrombolytic therapy were compared between the two groups. Results there was no significant difference in NIHSS score and Barthel index between the two groups before thrombolytic therapy and at the 15th day after thrombolytic therapy (P0.05). The NIHSS score in the observation group was significantly lower than that in the control group only 90 days after treatment. The Barthel index was significantly higher than that of the control group (P0.05). After 7 days of thrombolytic therapy, the total effective rate was 82.86 in the observation group and 75.00 in the control group. There was no significant difference between the two groups after 7 days of thrombolytic therapy (蠂 2, 0.658, P < 0.418). The rate of intracerebral hemorrhage after thrombolytic therapy in the two groups was significantly lower than that in the control group (P0.05). There was no significant difference in mortality at 7 days after thrombolytic therapy between the two groups (P0.05). Conclusion the short-term effect of rt-PA thrombolytic therapy in patients with VBA cerebral infarction is similar to that in time window 3.0h 4.5h, and the risk of death is the same. However, 3.0h time window can reduce the incidence of ICH, and the long-term effect is remarkable.
【作者单位】：承德医学院附属医院神经内科;
【基金】：承德市科学技术局科技支撑计划(201606A050)
【分类号】：R743.33

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