摘要
目的:探讨急性脑梗死患者静脉溶栓使用小剂量(0.6 mg/kg)阿替普酶的临床疗效及安全性。方法:将2016年1月至2019年12月我院神经内科收治的溶栓时间窗内40例急性脑梗死患者随机分为标准剂量组(0.9 mg/kg)和小剂量组(0.6 mg/kg),每组20例,分别在溶栓前、溶栓后1小时对患者进行美国国立卫生研究院卒中量表(NIHSS)评分,溶栓前和溶栓后24小时做头颅CT排除脑出血,密切监测不良反应。结果:标准剂量组有效率为80.00%,小剂量组有效率为75.00%,两组比较差异无统计学意义(P>0.05)。治疗前两组NIHSS评分比较差异无统计学意义(P>0.05),治疗后两组NIHSS评分均降低,与治疗前相比差异有统计学意义(P<0.05),治疗后两组NIHSS评分差异无统计学意义(P>0.05)。标准剂量组总不良反应发生率为40.00%,高于小剂量组的20.00%,差异无统计学意义(P>0.05)。结论:阿替普酶可有效改善急性脑梗死患者的神经功能,小剂量(0.6 mg/kg)与标准剂量(0.9 mg/kg)溶栓效果相当,安全性较好,出血事件发生率较低,可根据患者情况酌情选用小剂量。
Objective:To investigate the clinical efficacy and safety of low-dose(0.6 mg/kg)alteplase in patients with acute cerebral infarction.Methods:40 acute cerebral infarctionpatients within thrombolysis time window admitted in neurology department of our hospital from January 2016 to December 2019 were randomly divided into standard dose group(0.9 mg/kg)and small dose group(0.6 mg/kg),there were 20 cases in each group.National Institutes of Health Stroke Scale(NIHSS)scores were assessed before and 1 hour after thrombolysis.CT scan was performed before and 24 hours after thrombolysis to exclude cerebral hemorrhage and close monitor of adverse reactions.Results:The effective rate was 80.00%in standard dose group and 75.00%in small dose group,there was no significant difference between the two groups(P>0.05).There was no significant difference in NIHSS scores between the two groups before treatment(P>0.05).NIHSS scores in both groups were decreased after treatment,the difference was statistically significant compared with before treatment(P<0.05).There was no significant difference in NIHSS score between the two groups after treatment(P>0.05).The total incidence of adverse reactions was 40.00%in the standard dose group,which was higher than 20.00%in the small dose group,the difference was no statistically significant(P>0.05).Conclusion:Alteplase can effectively improve the neurological function of patients with acute cerebral infarction.The thrombolytic effect of low dose(0.6 mg/kg)is similar to that of standard dose(0.9 mg/kg),the safety is good and the incidence of bleeding is low.Small dose can be selected according to the patient’s condition.
作者
纪芳
李彬
王晓娟
杨莎莎
朱蕾
舒冰
薛敏
JI Fang;LI Bin;WANG Xiao-juan;YANG Sha-sha;ZHU Lei;SHU Bing;XUE Min(Department of Pharmaceutical,The First Affiliated Hospital of Anhui University of TechnologyHuainan First People's Hlospital,Huainan,Anhui,232007,China;Department of lnternal Neurology,The First Affiliated Hospital of Anhui University of Technology/Huainan First People's Hospital,Huainan,Anhui,232007,China;Department of Pharmacy,The First Alfiliated Hospital of University of Science and'Technology of China/Anhui Provincial Hospital,Hefei,Anhui,230001,China)
出处
《现代生物医学进展》
CAS
2020年第18期3592-3595,3600,共5页
Progress in Modern Biomedicine
基金
安徽高校自然科学研究重点项目(KJ2019A0096)
淮南市科技计划项目(2018A379)
蚌埠医学院自然科学类项目(BYKY2019315ZD)。
关键词
阿替普酶
静脉溶栓
急性脑梗死
不良反应
剂量
神经功能
Alteplase
Intravenous thrombolysis
Acute cerebral infarction
Adverse reaction
Dose
Neurological function
作者简介
纪芳(1983-),女,硕士,主管药师,研究方向:临床药学,E-mail:Fangfeifei666999@163.com;通讯作者:薛敏(1968-),男,本科,主任医师、硕士生导师,研究方向:神经内科疾病诊治,E-mail:597171524@qq.com。
