阿替普酶静脉溶栓治疗急性缺血性脑卒中疗效观察

目的 探讨阿替普酶静脉溶栓治疗急性缺血性脑卒中的临床疗效.方法 选择2014年1月至2016年7月我院神经内科应用阿替普酶静脉溶栓治疗的53例急性缺血性脑卒中患者为研究对象,记录美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数、临床疗效及不良反应发生情况.结果 治疗后24 h及14 d,NIHSS评分分别为(10.96±4.15)分、(6.15±2.58)分,较治疗前的(15.36±4.18)分依次下降,Barthel指数分别为(61.54±20.84)、(88.52±31.67),较治疗前的(48.17±19.62)依次升高,差异均有统计学意义(P<0.05);治疗有效率为90.59%,不良反应发生率为9.43%.单因素分析显示,无效组患者发病至溶栓时间长于有效组,糖尿病比例高于有效组,差异均有统计学意义(P<0.05).结论 阿替普酶静脉溶栓治疗急性缺血性脑卒中具有确切的临床疗效,可以明显改善患者的神经功能缺损及日常生活活动能力,具有较好的安全性,并且疗效与溶栓时间、糖尿病有关.

Clinical effect of alteplase intravenous thrombolysis in the treatment of acute ischemic stroke

Objective To study the clinical effect of alteplase intravenous thrombolysis in the treatment of acute ischemic stroke. Methods A total of 53 cases of patients with acute ischemic stroke, who underwent alteplase intrave-nous thrombolytic therapy from Department of Neurology of our hospital from January 2014 to July 2016, were selected as the subjects. The NIHSS score, Barthel index, clinical efficacy and adverse reaction were recorded. Results The NI-HSS scores were (10.96±4.15) and (6.15±2.58) points respectively at 24 h and 14 d after treatment, which were signifi-cantly lower than that before treatment (15.36 ± 4.18);Barthel index were repectively (61.54 ± 20.84) and (88.52 ± 31.67), which were significantly higher than that before treatment (48.17 ± 19.62) (P<0.05). The effective rate and adverse reac-tion rate were respectively 90.59%and 9.43%. Univariate analysis showed that the duration of onset of thrombolysis in the ineffective group was significantly longer than that in the effective group (P<0.05), and the diabete rate in the ineffec-tive group was significantly higher than that of the effective group (P<0.05). Conclusion Alteplase intravenous throm-bolytic has definite clinical effect in the treatment of acute ischemic stroke, which can significantly improve the patient's neurological deficit and activities of daily living, and also has good safety. Thrombolytic efficacy is closely related with thrombolysis time and diabetes.