| 纪 芳,李 彬,王晓娟,杨莎莎,朱 蕾,舒 冰,薛 敏.小剂量阿替普酶治疗急性脑梗死患者的临床疗效及安全性评价[J].,2020,(18):3592-3595 |
| 小剂量阿替普酶治疗急性脑梗死患者的临床疗效及安全性评价 |
| Clinical Efficacy and Safety of Low Dose Alteplase in the Treatment of Patients with Acute Cerebral Infarction |
| 投稿时间：2020-04-15 修订日期：2020-05-10 |
| DOI：10.13241/j.cnki.pmb.2020.18.043 |
| 中文关键词: 阿替普酶 静脉溶栓 急性脑梗死 不良反应 剂量 神经功能 |
| 英文关键词: Alteplase Intravenous thrombolysis Acute cerebral infarction Adverse reaction Dose Neurological function |
| 基金项目:安徽高校自然科学研究重点项目（KJ2019A0096）；淮南市科技计划项目（2018A379）；蚌埠医学院自然科学类项目（BYKY2019315ZD） |
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| 中文摘要: |
| 摘要 目的：探讨急性脑梗死患者静脉溶栓使用小剂量(0.6 mg/kg)阿替普酶的临床疗效及安全性。方法：将2016年1月至2019年12月我院神经内科收治的溶栓时间窗内40例急性脑梗死患者随机分为标准剂量组(0.9 mg/kg)和小剂量组(0.6 mg/kg)，每组20例，分别在溶栓前、溶栓后1小时对患者进行美国国立卫生研究院卒中量表（NIHSS）评分，溶栓前和溶栓后24小时做头颅CT排除脑出血，密切监测不良反应。结果：标准剂量组有效率为80.00%，小剂量组有效率为75.00%，两组比较差异无统计学意义（P＞0.05）。治疗前两组NIHSS评分比较差异无统计学意义（P>0.05），治疗后两组NIHSS评分均降低，与治疗前相比差异有统计学意义（P＜0.05），治疗后两组NIHSS评分差异无统计学意义（P＞0.05）。标准剂量组总不良反应发生率为40.00%，高于小剂量组的20.00%，差异无统计学意义（P＞0.05）。结论：阿替普酶可有效改善急性脑梗死患者的神经功能，小剂量(0.6 mg/kg)与标准剂量(0.9 mg/kg)溶栓效果相当，安全性较好，出血事件发生率较低，可根据患者情况酌情选用小剂量。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical efficacy and safety of low-dose (0.6 mg / kg) alteplase in patients with acute cerebral infarction. Methods: 40 acute cerebral infarctionpatients within thrombolysis time window admitted in neurology department of our hospital from January 2016 to December 2019were randomly divided into standard dose group (0.9 mg / kg) and small dose group (0.6 mg / kg), there were 20 cases in each group. National Institutes of Health Stroke Scale (NIHSS) scores were assessed before and 1 hour after thrombolysis. CT scan was performed before and 24 hours after thrombolysis to exclude cerebral hemorrhage and close monitor of adverse reactions. Results: The effective rate was 80.00% in standard dose group and 75.00% in small dose group, there was no significant difference between the two groups (P＞0.05). There was no significant difference in NIHSS scores between the two groups before treatment (P＞0.05). NIHSS scores in both groups were decreased after treatment, the difference was statistically significant compared with before treatment (P＜0.05). There was no significant difference in NIHSS score between the two groups after treatment (P＞0.05). The total incidence of adverse reactions was 40.00% in the standard dose group, which was higher than 20.00% in the small dose group,the difference was no statistically significant (P＞0.05). Conclusion: Alteplase can effectively improve the neurological function of patients with acute cerebral infarction. The thrombolytic effect of low dose (0.6 mg / kg) is similar to that of standard dose (0.9 mg / kg), the safety is good and the incidence of bleeding is low.Small dose can be selected according to the patient's condition. |
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