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1、重组组织型纤溶酶原激活剂治疗急性脑梗死的疗效评价[摘要]目的:评价重组组织型纤溶酶原激活剂(rt-PA)治疗急性脑梗死的疗效及安全性。方法:128例发病<6h的急性脑梗死患者随机分为治疗纟fl和对照纟R。对照纟fU、'、Z用常规治疗方法;治疗组在常规治疗方法的基础上采用rt-PA治疗,总剂量0.9mg/kg,战大剂量90mg,先在1min内静脉注射10%的剂量,其余90%的剂量连续静脉滴注,共计60min。两组治疗前及治疗后2、12、24h及3、7、14、30、90d时均采用《屮国脑卒屮临床神经功能缺损评分标准》(CSS)&Barthel(BI)指数进行评价
2、。结果:治疗组治疗后各时间点CSS及BI均明显改善(P<0.01),且显效率明显高于对照组(PV0.CH),出血发生率低。结论:应用rt-PA治疗急性脑梗死发病V6h更加安全、有效。[关键词]组织型纤溶酶原激活物;脑梗死;急性病;治疗[屮图分类号]R743.3[文献标识码]A[文章编号11673-7210(2009)01(b)-040-02Therapeuticeffectevaluationofrecombinanttissueplasminogentictiv&torinhyperacutecerebralinfarctionTANAn-xiongl,L
3、IJin-chengl,WANGYu-yin2,LIXiao-yun3(1.ShaoyangMedicalCollege,Shaoyang422000,China;2・TheSecondXiangyaHospitalofCentralSouthUniversity,Changsha410011,China;3.ShaoyangIntegratedTraditionalandWesternMedicineHospital,Shaoyang422000,Chirm)[Abstract]Objective:Toevaluatetheefficacyandsafet
4、yofrecombinanttissueplasminogenactivatorinhyperacutecerebralinfarction.Methods:128patientswithin6hoursaftertheonsetofstrokeweredividedintotwogroupsrandomly.Thepeopleinonegroupwerecuredbytraditionaltherapeuticmeans,whilepeopleinanothergroupweregivenrt-PAinadditiontothetraditionalthe
5、rapeuticmeans・Coneretelyspeaking,thetotaldosagewas0.9mg/kg,andthemaximumdosagewas90mg.Firstly,10%ofthedosagewasinjectedintoveinwithin1minute,thentherestwasdroppedintoveinwithin60minutes.TheCSSscoresandBIwereusedtoevaluateeffectsbeforetreatmentandat2h,12h,24h,3d,7d,14d,30dand90claft
6、ertreatmcntintwogroups・Results:TheCSSscoresandBIofgrouptwowhichwasgivenrt-PAwereimprovedattheseevaluatedtimepoints(P<0.01),andefficiencyofthisgroupwasobviouslyhigherthanthatofanother(P<0.01),alsothebleedingratewaslower•Conclusion:rt-PAinthetreatmentofACIpatientswithin6hoursafterthe
7、onsetisefficientandsafe.[Keywords]Recombinanttissueplasminogenactivalor;Cerebralinfarction;Acutedisease;Therapy急性脑梗死是临床上的常见病,且致残率、病死率均较高,其主要治疗措施是进行溶栓治疗,使阻寒的血管畅通。重组组织型纤溶酶原激活剂(rt-PA)已在多个国家被用于治疗急性脑梗死,但如何选择适当的溶栓治疗时间窗仍有待研究。为探讨我国急性脑梗死患者早期应用rt-PA静脉溶栓的有效性和安全性,笔者进行了本研究。1资料与方法1.1一般资料将128例急性脑
8、梗死患者随机分为2组,治疗组64例,男37例,女27