在线办公
期刊论坛
主 管
中国人民解放军总医院
主 办
中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
编 辑
中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
传真:010-66936756
E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
李刚,吉萍,赵东刚,陈少军,闫俊,汤华,姜莱,管玉华,郑刚,黄鑫.超早期溶栓治疗急性脑梗死的临床效果及安全性[J].中华老年多器官疾病杂志,2018,17(6):434~437
超早期溶栓治疗急性脑梗死的临床效果及安全性
Clinical efficacy and safety of ultra-early intravenous thrombolytic therapy for acute cerebral infarction
投稿时间:2018-01-10  修订日期:2018-04-03
DOI:10.11915/j.issn.1671-5403.2018.06.097
中文关键词:  静脉溶栓;超早期;急性脑梗死;凝血功能
英文关键词:intravenous thrombolysis; ultra-early stage; acute cerebral infarction; coagulation function
基金项目:
作者单位E-mail
李刚 三峡大学人民医院神经外科,宜昌 443000  
吉萍 三峡职业技术学院医学院,宜昌 443003 995366017@qq.com 
赵东刚 三峡大学人民医院神经外科,宜昌 443000  
陈少军 三峡大学人民医院神经外科,宜昌 443000  
闫俊 三峡大学人民医院神经外科,宜昌 443000  
汤华 三峡大学人民医院神经外科,宜昌 443000  
姜莱 三峡大学人民医院神经外科,宜昌 443000  
管玉华 三峡大学人民医院神经外科,宜昌 443000  
郑刚 三峡大学人民医院神经外科,宜昌 443000  
黄鑫 三峡大学人民医院神经外科,宜昌 443000  
摘要点击次数: 658
全文下载次数: 382
中文摘要:
      目的 探讨超早期静脉溶栓治疗急性脑梗死的临床效果及安全性。方法 回顾性分析三峡大学人民医院神经外科2014年1月至2017年4月收治的260例急性脑梗死患者的临床资料。依据是否超早期溶栓分为2组:溶栓组和对照组,每组130例。溶栓组患者采用重组人组织型纤溶酶原激活物在4.5 h时间窗内进行超早期溶栓治疗;对照组患者采用常规的抗凝、降压等常规治疗。对比2组患者在治疗后不同时间点的美国国立卫生院卒中量表(NIHSS)评分、Barthel指数、远期预后及患者的凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)]。采用SPSS 16.0软件进行数据处理。依据数据类型,组间比较分别采用t检验或χ2检验。结果 治疗24 h后,溶栓组患者的APTT[(32.9±2.8) vs(30.1±3.0)s]、PT[(13.7±1.6) vs(12.8±1.5)s]、TT[(17.3±1.0) vs(16.1±1.3)s]均高于对照组(P<0.05),溶栓组患者的FIB水平低于对照组[(2.6±0.4) vs(2.9±0.6)g/L,P<0.05]。治疗前,溶栓组和对照组的NIHSS评分差异无统计学意义(P>0.05);治疗后24 h、7 d、14 d、28 d后,溶栓组患者的NIHSS评分均显著低于同期对照组(P<0.05)。治疗后1、3、6个月,溶栓组患者的Barthel指数均显著高于同期对照组(P<0.05)。治疗6个月后,溶栓组患者预后良好率显著高于对照组(76.15% vs 64.62%,P<0.05)。溶栓组治疗过程中出现1例牙龈出血,2例鼻出血,13例静脉输液部位皮下出血,余未见其他严重不良反发生。结论 超早期静脉溶栓治疗可有效改善急性脑梗死患者的神经功能缺损症状,对远期康复具有重要意义。
英文摘要:
      Objective To explore the clinical efficacy and safety of ultra-early intravenous thrombolytic therapy in the treatment of acute cerebral infarction. Methods A retrospective study was performed on 260 patients with acute cerebral infarction in the Department of Neurosurgery from January 2014 to April 2017. Their clinical data were collected and analyzed. According to ultra-early thrombolysis or not, they were divided into thrombolytic group and control group, 130 cases in each group. Thrombolytic group was treated with recombinant human tissue plasminogen activator within a therapeutic window of 4.5 h, and the control group was given with conventional anticoagulation and antihypertensive therapy. National Institutes of Health Stroke Scale (NIHSS) score, Barthel index, long term prognosis and coagulation function, including activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen (FIB) at different time points after treatment were used to compare the efficacy of the 2 groups. SPSS statistics 16.0 was used for data processing. According to the data type, Students′t test or Chi-square test was used in the comparison between groups. Results After treatment for 24 h, the patients in the thrombolysis group had significantly longer APTT [(32.9±2.8) vs (30.1±3.0) s], PT [(13.7±1.6) vs (12.8±1.5) s] and TT [(17.3±1.0) vs (16.1±1.3) s] (all P<0.05), but obviously lower FIB level [(2.6±0.4) vs (2.9±0.6) g/L, P<0.05] when compared with those in the control group. Before treatment, there was no significant difference in NIHSS scores between the 2 groups (P>0.05), but the scores were notably lower in the thrombolysis group than the control group in 24 h, and 7,4 and 28 d after treatment (P<0.05). At 1,3, and 6 months after treatment, the Barthel index of patients in the thrombolysis group was significantly higher than that in the control group at the same time (P<0.05). After 6 months of treatment, the rate of good prognosis was significantly higher in the thrombolysis group than in the control group (76.15% vs 64.62%,P<0.05). In the thrombolysis group, there was 1 case of gingival bleeding, 2 cases of epistaxis, and 13 cases of subcu-taneous hemorrhage at the site of intravenous infusion, but no other serious adverse events occurred. Conclusion Ultra-early intravenous thrombolytic therapy can effectively improve the symptoms of neurological deficits in the patients with acute cerebral infarction, and is of great significance for long-term rehabilitation.
查看全文    下载PDF阅读器
关闭