摘要
目的观察急性缺血性脑卒中进行阿替普酶和重组人尿激酶原静脉溶栓治疗的临床研究对照。方法临床选择2019年1月至2021年1月在东莞市中堂医院接受诊治的急性缺血性脑卒中病人40例,根据随机对照法分组,分为试验组(n=20)、对照组(n=20),试验组应用注射用重组人尿激酶原(普佑克)溶栓,对照组应用阿替普酶(爱通立)溶栓治疗,比较两组给药后90天mRS评分0~1的受试者比例;比较两组的不良事件的发生率;比较两组给药后24h NHISS评分与基线相比的差值、给药后90天NHISS评分;比较两组给药后24h NIHSS评分较基线下降≥4分(或NIHSS评分≤1)的受试者比率。结果试验组给药后90天mRS评分0-1的受试者比例、给药后24h NIHSS评分较基线下降≥4分(或NIHSS评分≤1)的受试者比率显著高于对照组(P<0.05);试验组给药后24h NHISS评分与基线相比的差值显著高于对照组(P<0.05);试验组给药后90天NHISS评分显著低于对照组(P<0.05);试验组7天内全因死亡、明确的缺血性脑卒中复发、90天内全因死亡、症状性颅内出血事件、严重系统性出血事件等的发生率显著与对照组相比,差异无统计学意义(P>0.05)。结论急性缺血性脑卒中进行重组人尿激酶原静脉溶栓治疗可显著改善病人的神经功能缺损程度,不良事件发生比例较低,用药的有效性和安全性较高,值得临床推广。
Objective To make the clinical controlled trials of intravenous thrombolysis therapy with recombinant human prourokinase and alteplase in treating acute ischemic stroke.Methods 40 acute ischemic stroke patients treated from January 2019 to January 2021 in Zhongtang Town Hospital were selected and divided into test group(n=20)and control group(n=20)according to randomized controlled method.The test group took the recombinant human prourokinase for injection;the control group took recombinant human tissue plasminogen activator for injection(actilyse).Group contrasts were performed about the proportions of patients with 0~1 mRS(modified Rankin scale)scores after 90d of medication,adverse event rates,difference values of NIHSS(national institutes of health stroke scale)scores with baseline values after 24h of medication,NIHSS scores after 90d of medication,proportions of patients with declining NIHSS scores≥4 or≤1 after 24h of medication to the baseline values.Results The proportions of patients with 0-1 mRS(modified Rankin scale)scores after 90d of medication and the proportions of patients with declining NIHSS scores≥4 or≤1 after 24h of medication to the baseline values in the test group were significantly higher than control group(P<0.05);the difference values of NIHSS scores with baseline values after 24h of medication in the test group were significantly higher than control group(P<0.05);NIHSS scores after 90d of medication in the test group were significantly lower than control group(P<0.05);there were no significant between-group differences about the incidences of adverse reactions like 7-day all-cause mortality,recurrent ischemic stroke,90-day all-cause mortality,symptomatic intracranial hemorrhage and serious systematic hemorrhage(P>0.05).Conclusion The intravenous thrombolysis therapy with recombinant human prourokinase can reduce the incidences of neurologic impairment and adverse events,and increase the medication effectiveness and safety.It is worthy of clinical promotion.
作者
陈峰
吴克文
袁锦波
CHEN Feng;WU Ke-wen;YUAN Jin-bo(Internal Medicine Department Ⅱ,Zhongtang Town Hospital,Dongguan,Guangdong 523220)
出处
《智慧健康》
2021年第19期134-136,141,共4页
Smart Healthcare
基金
东莞市社会科技发展项目(项目编号:202050715016187)
关键词
急性缺血性脑卒中
阿替普酶
重组人尿激酶原
静脉溶栓
Acute ischemic stroke
Alteplase
Recombinant human prourokinase
Intravenous thrombolysis
作者简介
陈峰(1985-),男,广东省兴宁市,神经主治医师,大学本科,研究方向:神经内科。
