阿替普酶与尿激酶治疗急性轻型脑梗死的疗效及安全性分析

目的分析阿替普酶与尿激酶治疗急性轻型脑梗死的疗效及安全性。方法回顾性收集2018-03—2019-06在保定市第一中心医院神经内四科住院的急性轻型脑梗死患者73例,均接受静脉溶栓治疗。根据所用溶栓药物分为阿替普酶组41例,尿激酶组32例。通过分析2组患者静脉溶栓后2 h、24 h、3 d、7 d NIHSS评分及治疗期间的出血、早期神经功能恶化、纤维蛋白原减少、死亡等不良事件,分析两种静脉溶栓方案对于急性轻型脑梗死患者的疗效及安全性。结果阿替普酶组静脉溶栓后2 h、24 h、3 d、7 d NIHSS评分分别为2(1,3)、1(1,4)、1(1,4)、1(0,3.5),均低于其基线NIHSS评分3(1.5,4),差异均有统计学意义(分别为P=0.016、0.039、0.042、0.006);尿激酶组静脉溶栓后7 d NIHSS评分为1(0,3),低于其基线NIHSS评分2(1.3,4),差异有统计学意义(P=0.013)。阿替普酶组与尿激酶组静脉溶栓后2 h、24 h、3 d、7 d NIHSS评分差异均无统计学意义(分别为P=0.734、0.897、0.852、0.864),且2组患者出血并发症及总不良事件的发生率差异无统计学意义(P>0.05)。结论尿激酶与阿替普酶治疗急性轻型脑梗死均有效,且疗效及安全性相当。

Efficacy and safety of alteplase and urokinase for treatment of acute mild cerebral infarction

Objective To compare the efficacy and safety of alteplase and urokinase in the treatment of patients with acute mild cerebral infarction.Methods Clinical data were collected retrospectively from 73 patients with acute mild cerebral infarction who underwent intravenous thrombolysis in Neurology 4th Department of Baoding First Central Hospital.The patients were divided into two groups:41 patients were treated with alteplase,and 32 patients were treated with urokinase.The efficacy and safety of the two treatment regimens were evaluated by analyzing NIHSS at 2 hours,24 hours,3 days,7 days after thromblysis and the adverse events such as hemorrhage,early neurological deterioration,fibrinogen reduction and death during treatment.Results The NIHSS scores of 2 hours,24 hours,3 days,7 days after thrombolysis are 2(1,3),1(1,4),1(1,4),1(0,3.5),respectively,lower than the initial NIHSS scores 3(1.5,4)in the alteplase group,and the differences are statistically significant(P values are 0.016,0.039,0.042,0.006,respectively).The NIHSS scores of 7 days after thrombolysis are 1(0,3),lower than the initial NIHSS scores 2(1.3,4)in the urokinase group,the differences are statistically significant(P=0.013).The differences between NIHSS scores of the alteplase group and urokinase group at 2 hours,24 hours,3 days,7 days after thrombolysis were not statistically significant(P values are 0.734,0.897,0.852,0.864,respectively).The differences of bleeding rates and total adverse events were not statistically significant(P>0.05).Conclusion Alteplase and urokinase are both effective for the treatment of acute mild cerebral infarction,and the efficacy and safety of the two treatments are equivalent.