摘要
目的探讨重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt—PA)静脉溶栓治疗缺血性卒中的预后与溶栓后24h及72h动脉收缩压变化的关系,研究血压变化规律作为提示溶栓预后早期指标的可能。方法用回顾性研究方法,对112例接受了rt—PA静脉溶栓治疗的超早期缺血性卒中患者按90d的预后分为预后不良(改良Rankin评分2～5)和预后良好(改良Rankin评分0～1)两组,比较这两组患者在溶栓前及治疗后24h及72h的动脉收缩压变化情况。结果预后不良组溶栓治疗后24h收缩压降低为(7±8)mmHg,而预后良好组同期为(10±8)mmHg,两组间比较差异有统计学意义(P<0.05)。预后不良组溶栓后72h收缩压降低为(8±8)mmHg,预后良好组为(1 0±8)mmHg,两组间比较差异无统计学意义(P>0.05)。结论预后良好组溶栓治疗后24h内动脉收缩压下降幅度明显高于预后不良组,而溶栓后72h这种差异已经不明显。溶栓后24h收缩压的明显下降可能与溶栓治疗90d时的良好预后相关。
Objective To investigate the relationship between the clinical outcomes ofthrombolysis treatment using recombinant tissue plasminogen activator （rt-PA） in patients with ultra-acute cerebral infarction and the changes of systolic pressure in 24h and 72h after treatment. Methods One hundred and twelve patients with ultra-acute cerebral infarction treated by intravenous rt-PA were assigned to the poor outcome group[90d modified Rankin Score （mRS） 2-5] and the good outcome group （90d mRS 0-1）. The changes of systolic pressure of enrolled patients were recorded at time of pre-treatment and 24h and 72h post-treatment respectively. Then these changes were compared between two groups. Results The decreases of systolic pressure in 24h after treatment in poor outcome group was （7 ±8）mmHg, comparing with the （10±8） mmHg in good outcome group, There was a statistically significant difference （t=-2.20, P=0.032） of systolic blood pressure variety between the two groups. The decreases of systolic pressure in 72h post-treatment in the two groups were （8±8）mmHg and （10±8）mmHg respectively. There was not a statistically significant difference （t=-1.52, P=0.13） between two groups. Conclusion The descending of systolic blood pressure in 24h after thrombolysis treatment in good outcomes group was more obvious than that in poor outcomes group. But this difference did not appear in 72h post-treatment. The degree of the systolic pressure decreasing in 24h after rt-PA thrombolysis potentially was related positively with benign prognosis after 90d.
出处
《中国卒中杂志》
2010年第2期115-118,共4页
Chinese Journal of Stroke
关键词
纤溶酶原激活剂
血栓溶解疗法
血压
预后
Plasminogen activators
Thrombolytic therapy
Blood pressure
Prognosis
