【摘 要】
：
目的：比较在重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓前或后分别联合依达拉奉治疗急性脑梗死的有效性和安全性.方法：回顾性分析江苏省卒中研究协作组织共5家医院行rt-PA(0.gmg/kg)静脉溶栓联合依达拉奉治疗的急性脑梗死(发病0.050).②A组溶栓后24h、出院时NIHSS评分较B组有显著改善(P=0.004、0.038)；3月后好转率(mRS评分0-1)A组61.1％、B组36.4％,
【机 构】
：
中国南京医科大学第二附属医院神经内科
【出 处】
：
2014第五届国际神经科技大会暨2014首届国际高科技针灸和中西医结合大会
论文部分内容阅读
目的：比较在重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓前或后分别联合依达拉奉治疗急性脑梗死的有效性和安全性.方法：回顾性分析江苏省卒中研究协作组织共5家医院行rt-PA(0.gmg/kg)静脉溶栓联合依达拉奉治疗的急性脑梗死(发病<4.5h)患者203人,根据rt-PA静脉溶栓前或后使用依达拉奉分为两组,溶栓前依达拉奉干预组(A组)99人为入院后先予依达拉奉30mg,然后予rt-PA静脉溶栓,溶栓结束后再予依达拉奉30mg；溶栓后依达拉奉干预组(B组)1 04人为入院后先予rt-PA静脉溶栓,然后再予依达拉奉30mg bid.对两组治疗前、治疗后24h、出院时的神经功能缺损(NIHSS)评分及治疗3月后的mRS评分进行比较,同时观察两组溶栓后脑出血发生率及7天、3月死亡率.结果：①两组基线资料无统计学差异(P>0.050).②A组溶栓后24h、出院时NIHSS评分较B组有显著改善(P=0.004、0.038)；3月后好转率(mRS评分0-1)A组61.1％、B组36.4％,两组比较有统计学差异(P=0.001)o③治疗后A、B两组脑出血发生率分别为9.1％、18.3％,无统计学差异(P=O.058)；症状性脑出血发生率分别为2％、8.7％,有统计学差异(P=0.037).治疗后7天死亡率分别为4％、4.9％,无统计学差异(P=1.000)；3月死亡率分别为4％、12.5％,有统计学差异(P=0.030).结论：联合应用依达拉奉可提高rt-PA静脉溶栓的有效性和安全性；rt-PA静脉溶栓前使用依达拉奉对3月后神经功能恢复优于溶栓后使用,同时可明显降低症状性脑出血发生率.
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