rt-PA和尿激酶静脉溶栓治疗急性脑梗死安全性比较及对血栓弹力图的影响

目的 比较rt-PA和UK在我国常规临床实践中对发病6 h内缺血性卒中(AIS)的疗效和安全性.比较rt-PA与UK这两种溶栓剂对血栓弹力图(TEG)各参数的影响,TEG各参数与rt-PA、UK静脉溶栓安全性的关系.方法 收集安徽医科大学附属巢湖医院2018年7月至2021年2月期间、接受rt-PA(4.5 h内)或U...

Comparison of safety of intravenous thrombolytic therapy with rt-PA and urokinase in acute cerebral infarction and its effect on thromboelastogram

Objective To compare the efficacy and safety of rt-PA and UK in the treatment of ischemic stroke(AIS)within 6 hours of onset in routine clinical practice in China.To compare the effects of rt-PA and UK on various parameters of thrombelastogram(TEG),and the relationship between various parameters of thrombelastogram and the safety of intravenous thrombolytic therapy of rt-PA and UK were compared.Methods A total of 102 AIS patients who received intravenous thrombolytic therapy of rt-PA(within 4.5 h)or UK(within 6 h)in chaohu hospital affiliated to anhui medical university from July 2018 to February 2021 were collected.including 59 patients who received rt-PA and 43 patients who received urokinase.NIHSS scores of patients on admission and before thrombolytic therapy,NIHSS scores of patients 14 days after thrombolytic therapy(or at discharge),complications of intracranial hemorrhage and digestive tract hemorrhage,and the number of deaths during hospitalization of patients in the two groups were recorded.At the same time,TEG parameters(including R,MA,K,αAngle and CI)after intravenous thrombolysis were recorded,and the indicators of R,MA,K,αAngle and CI of rt-PA group and UK group were compared and analyzed.Results There were no significant differences in neurological improvement,mortality,incidence of intracranial hemorrhage and digestive tract hemorrhage between rt-PA group and UK group(P>0.05).There were statistically significant differences in MA value between rt-PA group and urokinase group.The mean R value of patients with bleeding complications(bleeding group)was higher than that of non-bleeding group,and the difference was statistically significant.Conclusions Rt-PA and UK have similar efficacy and safety in AIS patients.Both rt-PA and UK can improve the prognosis of AIS patients.After intravenous thrombolysis,the hypocoagulant state of the UK group may be more significant than that of the rt-PA group,and the R time of the bleeding group is longer than that of the non-bleeding group,which has a certain predictive effect on the hemorrhage of acute cerebral infarction after intravenous thrombolysis.