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目的探讨不同剂量阿替普酶在急性缺血性脑卒中静脉溶栓治疗中的应用效果。方法选取开封市祥符区第一人民医院2014年4月—2016年3月收治的急性缺血性脑卒中患者81例,随机分为对照组(n=40)和观察组(n=41)。对照组患者给予低剂量阿替普酶治疗,观察组患者给予标准剂量阿替普酶治疗。观察比较两组患者用药24 h、3个月美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分,临床疗效,血管再通情况,病死、自发性脑出血发生及预后情况。结果观察组患者用药24 h、3个月后NIHSS评分及mRS评分均低于对照组(P<0.05)。两组患者临床疗效比较,差异无统计学意义(P>0.05)。观察组患者阻塞血管再通良好率高于对照组(P<0.05)。两组患者用药7 d、3个月病死率及自发性脑出血发生率比较,差异无统计学意义(P>0.05)。观察组患者预后良好率高于对照组(P<0.05)。结论标准剂量阿替普酶治疗急性缺血性脑卒中,可有效改善患者神经功能缺损程度和生活能力,促进阻塞血管再通,改善预后,且安全性高。
Objective To investigate the effect of different doses of alteplase in thrombolytic therapy of acute ischemic stroke. Methods Eighty-one patients with acute ischemic stroke who were admitted to the First People’s Hospital of Xiangfu District, Kaifeng City from April 2014 to March 2016 were randomly divided into control group (n = 40) and observation group (n = 41) . Control group patients given low-dose alteplase treatment, observation group patients given standard dose alteplase treatment. Observations and comparisons of NIHSS score, mRS score, clinical efficacy, recanalization, death and spontaneous ICH were observed in 24 h and 3 months in both groups Prognosis. Results The NIHSS score and mRS score of observation group were lower than those of control group at 24 h and 3 months after treatment (P <0.05). The clinical efficacy of two groups of patients, the difference was not statistically significant (P> 0.05). The good rate of occlusion revascularization in observation group was higher than that in control group (P <0.05). There was no significant difference between the two groups in the 7-day and 3-month mortality rates and the incidence of spontaneous cerebral hemorrhage (P> 0.05). The good prognosis of the observation group was higher than that of the control group (P <0.05). Conclusion The standard dose of alteplase for acute ischemic stroke can effectively improve the degree of patients with neurological deficits and life skills, promote occlusion of vascular recanalization, improve prognosis, and high safety.