Effect of intravenous thrombolysis with Alteplase on neurological function,coagulation parameters and prognosis in patients with acute cerebral infarction
WU Shou-xian KE Yong-yuan
Department of Emergency,the Second People′s Hospital of Foshan,Guangdong Province,Foshan 528000,China
摘要目的 探讨急诊阿替普酶静脉溶栓对急性脑梗死患者神经功能、凝血指标及预后的影响。方法 选取2019年1月—2020年6月佛山市第二人民医院急诊科收治的116 例急性脑梗死患者作为研究对象，根据患者或者其家属最终选择的治疗方案分为观察组（62 例）和对照组（54 例）。观察组采用阿替普酶静脉溶栓治疗，对照组给予急性脑梗死常规治疗。对比两组治疗前、治疗后24 h、14 d 的美国国立卫生研究院卒中量表（NIHSS）评分，比较两组治疗前及治疗后24 h 凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）水平，对比两组预后及不良反应发生情况。结果 两组治疗后24 h、14 d 的NIHSS 评分均低于治疗前，且观察组均低于对照组，差异有统计学意义（P<0.05）。两组治疗前、治疗后24 h 的PT、TT、APTT、FIB 水平组内和组间比较，差异均无统计学意义（P>0.05）。观察组的预后优于对照组，差异有统计学意义（P<0.05）。两组的不良反应总发生率比较，差异无统计学意义（P>0.05）。结论 急诊阿替普酶静脉溶栓对急性脑梗死患者神经功能及预后有显著改善作用，且对患者的凝血功能影响小。
Abstract：Objective To investigate the effect of intravenous thrombolysis with Alteplase on neurological function,coagulation parameters and prognosis in patients with acute cerebral infarction.Methods A total of 116 patients with acute cerebral infarction admitted to the Department of Emergency of the Second People′s Hospital of Foshan from January 2019 to June 2020 were selected as the research objects.According to the final treatment plan selected by the patient or his family,the patients were divided into the observation group(62 cases)and the control group(54 cases).The observation group was given intravenous thrombolytic therapy with Alteplase,and the control group was given conventional treatment for acute cerebral infarction.The National Institutes of Health stroke scale(NIHSS)scores before treatment,24 h and 14 d after treatment were compared between the two groups.The levels of prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)were compared between the two groups before and 24 h after treatment.The prognosis and incidence of adverse reactions were compared between the two groups.Results the NIHSS scores at 24 h and 14 d after treatment in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the levels of PT,TT,APTT,FIB between the two groups before and 24 h after treatment(P>0.05).The prognosis of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Emergency intravenous thrombolysis with Alteplase can significantly improve the neurological function and prognosis of patients with acute cerebral infarction,and has little effect on coagulation function.
吴守贤； 柯永源. 急诊阿替普酶静脉溶栓对急性脑梗死患者神经功能、凝血指标及预后的影响[J]. 中国当代医药, 2021, 28(22): 107-109转113.
WU Shou-xian； KE Yong-yuan. Effect of intravenous thrombolysis with Alteplase on neurological function,coagulation parameters and prognosis in patients with acute cerebral infarction. 中国当代医药, 2021, 28(22): 107-109转113.
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