阿替普酶在老年急性脑梗死患者中疗效和安全性分析

目的探究阿替普酶在老年急性脑梗死患者(年龄≥65岁)中疗效及安全性。方法选取2017年1月-2019年7月于海南省干部疗养院就诊的188例老年急性脑梗死患者,根据年龄分为超高龄组(年龄>80岁,n=82)级老年组(年龄65~80岁,n=106)。患者入院后均接受阿替普酶0.9 mg/kg静脉溶栓。采用NIHSS评估患者疗效,根据治疗后14d累积有效率绘制生存曲线,并观察患者不良反应及生存率。结果超高龄组患者合并.高血压、合并房颤比例高于老年组(P<0.05)。术后14d,两组患者有效率比较差异无统计学意义(P>0.05),超高龄组平均有效时间长于老年组(P<0.05)。老年组及超高龄组总不良反应发生率、死亡率差异无统计学意义(P>0.05)。Kaplan-Meier法并Log-rank检验提示老年组累积有效率下降较快,超高龄组累积有效率下降缓慢,但两组组累积有效率差异无统计学意义(P>0.05)。结论阿替普酶在65~80岁及80岁以上的老年急性脑梗死患者中均具有较好的临床疗效,且安全性较高。

Analysis of efficacy and safety of alteplase in elderly patients with acute cerebral infarction

Objective Explore the fficacy and safety of alteplase in elderly patients with acute cerebral infarction(age≥65 years).Methods I 88 elderly patients with acute cerebral infarction who were treated in our hospital from January 2017 to July 2019 were selected and divided into senior group(age 65-80 years old,n=106)and super senior group(age 80 years old,n=82).All patients received intravenous thrombolysis with alteplase 0.9 mg/kg after admission.NIHSS was used to evaluate the efficacy of the patients,and survival curves were drawn based on the cumulative effective rate after 14 days of treatment,and the adverse reactions and survival rates of the patients were observed.Results The pro-portion of patients with hypertension and atrial fibrillation in super senior group was higher than that in group A,and the difference was statistically significant(P<0.05).At 14 days after surgery,there was no statistically significant differ-ence in the effective rate between the two groups(P>0.05).The average effctive time of super senior group was longer than that of senior group(P<0.05).Kaplan-Meier method and Log-rank test showed that the cumulative effective rate of the ultra-old age group decreased slowly,and the cumulative effective rate of the elderly group decreased rapidly,but there was no statistically significant difference in the cumulative effective rate between the two groups(P>0.05).There was no significant difference in the incidence of total adverse reactions and mortality between the elderly group and the ultra-old age group(P>0.05).Conclusion Alteplase has good clinical efficacy and high safety in elderly pa-tients with acute cerebral infarction aged 65-80 years and over.