顾亮亮;付国惠;张保朝;邢娟;

• 1:南阳市中心医院神经内科

摘要(Abstract)：

目的探讨低剂量重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt-PA)联合尿激酶静脉溶栓治疗椎基底动脉系统脑梗死的疗效及安全性。方法选取100例椎基底动脉系统脑梗死患者,随机分为联合组、rt-PA组、尿激酶组和对照组各25例。比较各组患者神经功能缺损量表(NIHSS)评分、日常生活能力量表(ADL)、临床疗效、脑出血发生率及再梗死率。结果治疗后,各组NIHSS评分均较治疗前显著降低(P<0.05),且联合组、rt-PA组及尿激酶组显著低于对照组(P<0.05),但联合组、rt-PA组及尿激酶组间比较无显著差异(P>0.05)。与治疗前相比,各组治疗后ADL评分显著提高(P<0.05),且联合组、rt-PA组及尿激酶组显著高于对照组(P<0.05),但联合组、rt-PA组及尿激酶组间比较差异无统计学意义(P>0.05)。联合组、rt-PA组及尿激酶组有效率均显著高于对照组(P<0.05),但联合组、rt-PA组及尿激酶组间比较差异无统计学意义(P>0.05)。各组再发脑梗死率比较差异无统计学意义(P>0.05),联合组脑出血发生率显著低于rt-PA组、尿激酶组(P<0.05)。结论低剂量rt-PA联合尿激酶静脉溶栓治疗椎基底动脉系统脑梗死安全有效,并可有效降低脑出血发生率。

关键词(KeyWords)： 椎基底动脉系统;脑梗死;静脉溶栓;rt-PA;尿激酶

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 顾亮亮;付国惠;张保朝;邢娟;

参考文献(References)：

• [1]Menon BK,Saver JL,Goyal M,et al.Trends in endovascular therapy and clinical outcomes within the nationwide get with the guidelines-stroke registry[J].Stroke,2015,46(4):989-995.
• [2]Osaki M,Miyashita F,Koga M,et al.Simple clinical predictors of stroke outcome based on National Institutes of Health Stroke scale score during 1-h recombinant tissuetype plasminogen activator infusion[J].Eur J Neurol,2014,21(3):411-418.
• [3]Kim K,Kim YM,Kim EK.Correlation between the Activities of Daily Living of Stroke Patients in a Community Setting and Their Quality of Life[J].J Phys Ther Sci,2014,26(3):417-419.
• [4]欧阳取平,李亚梅.不同时间窗阿替普酶静脉溶栓治疗急性脑梗死患者的临床分析[J].中华老年心脑血管病杂志,2014,16(9):984-985.
• [5]Pfefferkorn T,Mayer TE,Opherk C,et al.Staged escalation therapy in acute basilar artery occlusion intravenous thrombolysis and on-demand consecutive endovascular mechanical thrombectomy:preliminary experience in 16patients[J].Stroke,2008,39(5):1 496-1 500.
• [6]Levine SR,Khatri P,Broderick JP,et al.Review,Historical Context,and Clarifications of the NINDS rtPA StrokeTrials Exclusion Criteria Part 1:Rapidly Improving Stroke Symptoms[J].Stroke,2013,44(9):2 500-2 505.
• [7]许建强,李永鸿,霍保善,等.乌司他丁联合尿激酶治疗急性脑梗死的效果[J].广东医学,2014,35(14):2 273-2 275.
• [8]Wahlgren N,Ahmed N,Dávalos A,et al.Thrombolysis with alteplase 3-4.5 h after acute ischaemic stroke(SITS-ISTR):an observational study[J].Lancet,2008,372(9 646):1 303-1 309.
• [9]张国鲁,张微微,黄勇华,等.重组组织型纤溶酶原激活剂联合尿激酶治疗急性脑梗死的临床观察[J].中华老年心脑血管病杂志,2012,14(5):507-510.
• [10]党哲,张国鲁,张微微,等.rt-PA联合尿激酶静脉溶栓治疗急性脑梗死的疗效及安全性研究[J].脑与神经疾病杂志,2014,22(4):287-291.