摘要
目的观察重组组织型纤溶酶原激活剂（rt—PA）静脉溶栓治疗早期急性脑梗死的疗效和安全性。方法将75例急性脑梗死（发病时间〈3h）患者随机分为2组：溶栓组40例用rt—PA0．9mg／kg，先于2min内静脉注射总量中的10％，再将余量于1h内静脉泵入；对照组35例不使用rt—PA。2组其他治疗均相同。观察治疗前及治疗后6h、24h、7d、30d、90d的临床神经功能缺损程度评分（CSS），治疗前、治疗后90d日常生活活动量表（Barthel指数），30d脑出血率、病死率。结果溶栓组溶栓后6h、24h、7d、30d、90dCSS为15．38，13．24，9．30，7．40，5．00分；90d总显效率为76％；90dBarthd指数评分为95～100分者占57％；脑出血率为10％；病死率为5％。对照组治疗后6h、24h、7d、30d、90dCSS为20．65，18．78，14．90，13．00，11，95分；90d总显效率为30％；90dBarthel指数评分为95～100分者占22％；无颅内出血；病死率为9％。溶栓组CSS明显低于对照组（P〈0．01），总显效率明显高于对照组（P〈0．01）。结论急性脑梗死早期应用rt—PA静脉溶栓是安全有效的。
Objective It is to observe the efficacy and safety of recombinant tissue plasminogen activator （rt- PA） intravenous thrombolysis on patients with early acute cerebral infarction. Methods 75 cases of acute cerebral infarction within 3 hours from the onset of stroke were randomly divided into two groups： intravenous thrombolysis group （40 cases） and control group （35 cases）, rt- PA was administrated in a dose of 0.9mg/kg, 10% of total dose was injected intravenously in 2 minutes, and the rest was infused in 1 hour for intravenous thrombolysis group. The control group received only routine treatment. Scoring Clinical Stroke Scale （C.SS） before treatment, in 24 hours, 7 days, 30 days and 90 days after treatment, Barthel index （BI）, mortality and side effects before treatment and 90days after treatment were all observed. Results Scoring of C.SS 6 hours, 24 hours 7 days, 30 days and 90 days after treatment were 15.38, 13.24, 9.30, 7.40, 5.00 in intra- venous thrombolysis group, and 20.65, 18.78, 14.90, 13.00, 11.95 in control group. High score of BI （ 95 -- 100） at 90 days after treatment were 57 % in intravenous thrombolysis group and 22 % in control group. The efficacy rate and mortality rate were 76 %, 5 % in intravenous thrombolysis group, and 30 % , 9 % in control group. All the data showed there were significant differences in CSS and total effective rate between the two groups （P〈 0.01 ）. Conclusion Early application of rt- PA intravenous thrombolysis is effective and safe for patients with acute cerebral infarction.
出处
《现代中西医结合杂志》
CAS
2008年第4期494-496,共3页
Modern Journal of Integrated Traditional Chinese and Western Medicine
