摘要
目的:本研究旨在探讨阿替普酶静脉溶栓治疗轻型致残性急性缺血性卒中的有效性和安全性。方法:选取2023年06月01日至2024年12月31日期间就诊于广东省廉江市人民医院神经内二科的急性轻型致残缺血性脑卒中患者100例[美国国立卫生研究院卒中量表(NIHSS)评分总分≤5分且意识状态评分为0分,脑卒中改良Rankin量表(Modified Rankin Scale,mRS)评分=2分]为研究对象,根据患者是否应用阿替普酶溶栓治疗分成两组,各50例,观察组为接受阿替普酶治疗,对照组为未接受阿替普酶治疗;收集患者入院3天、7天、14天美国国立卫生研究院卒中量表(NIHSS)评分和90d生活能力(mRS)评分变化,评定近期、远期疗效,以颅内出血、早期神经功能恶化发生率评估安全性并随访90d的脑卒中复发率。所有入组患者保证入组后90d随访时间,随访方式包括门诊和电话随访。主要终点为入院后2周内NIHSS评分变化,次要终点为治疗后90d改良Rankin’s生活能力(mRS)评分。观察两组患者治疗前后的NIHSS评分变化、入院时及90d的mRS评分、颅内出血率、复发率及死亡率。结果:治疗前,两组患者的NIHSS评分和mRS评分相比,差异无统计学意义(P>0.05);治疗后,观察组患者的NIHSS评分和mRS评分均较对照组低,差异具有统计学意义(P<0.05);观察组早期神经功能恶化发生率较对照组低,差异具有统计学意义(P<0.05);观察组颅内出血率、卒中相关性肺炎、复发率及死亡率与对照组相比,差异均无统计学意义(P>0.05)。结论:阿替普酶治疗轻型致残缺血性脑卒中有效且安全。
Objective:The purpose of this study was to investigate the effectiveness and safety of alteplase intravenous thrombolysis in the treatment of mildly disabling acute ischemic stroke.Methods:100 patients with acute mildly disabled ischemic stroke were selected from June 1,2023 to December 31,2024,who were treated in the Department of Neurology of the People's Hospital of Lianjiang City,Guangdong Province.The total score of the National Institutes of Health stroke scale(NIHSS)was less than 5 points.The consciousness status score was 0 and the Modified Rankin(mRS)score=2 were the subjects.The patients were divided into two groups,50 patients each,and the observation group was treated with alteplase.The control group was not treated with alteplase;The changes of National Institutes of Health stroke scale(NIHSS)scores and mRS scores at 90 days were collected at 3 days,7 days and 14 days,and the short-term and long-term effects were evaluated.The rate of intracranial hemorrhage and early neurological deterioration was evaluated and the recurrence rate of stroke was followed up for 90 days.All enrolled patients were guaranteed a 90-day follow-up time after enrollment,including outpatient and telephone follow-up.The primary end point was the change in NIHSS score within 2 weeks after admission,and the secondary end point was the 90-day post-treatment Modified Rankin's mRS score.The changes of NIHSS scores before and after treatment,mRS scores at admission and 90 days,intracranial hemorrhage rate,recurrence rate and mortality rate were observed.Results:Before treatment,there was no significant difference between the NIHSS score and mRS score of the two groups(P>0.05).After treatment,the NIHSS score and mRS score of patients in the observation group were lower than those in the control group,and the difference was significant(P<0.05).The incidence of early neurological function deterioration in the observation group was lower than that in the control group,and the difference.
作者
陆文欣
麦永佳
刘素玲
吴立宽
陈宗梅
曹华洲
Lu Wenxin;Mai Yongjia;Liu Suling;Wu Likuan;Chen Zongmei;Cao Huazhou(Department of Neurology II,Lianjiang People's Hospital,Lianjiang,Guangdong 524400)
基金
2023年度第三批湛江市非资助科技攻关计划项目(2023B01114)。
