摘要
摘要目的评估重组组织型纤溶酶原激活剂(rt－PA)治疗心源性脑栓塞的有效性和安全性.方法采用回顾性分析方法,选取我院心源性脑栓塞患者５９例,其中溶栓组３４例、非溶栓组２５例.比较两组患者基线、２４h、７d、９０d的神经功能缺损情况、早期改善及预后良好的比例、梗死后脑出血转化的发生率及９０d患者死亡率.结果两组患者基线美国国立卫生研究院卒中量表(NIHSS)评分及改良型Rankin量表(mRS)评分差异无统计学意义.发病２４h、７d后,溶栓组的NIHSS改善百分比优于非溶栓组(p＝０．００７和０．０１).发病９０d,溶栓组NIHSS预后良好百分比与非溶栓组比较,差异无统计学意义(p＝１．００).溶栓组２４h出血转化情况较非溶栓组严重(p＝０．０４),７d出血转化情况与非溶栓组比较差异无统计学意义(p＝０．５７).发病９０d,溶栓组与非溶栓组患者死亡例数分别为１１例和１０例,差异无统计学意义(p＝０．５４).结论rt－PA用于治疗心源性脑栓塞能够提高早期改善百分比,但同时会增加早期出血转化风险;在远期预后、总体出血转化及死亡情况方面与常规抗凝治疗无明显差异.关键词重组组织型纤溶酶原激活剂;心源性脑栓塞;溶栓;出血转化AbstractObjectiveToevaluatetheeffectivenessandsafetyofintravenousrecombinanttissueplasminogenactivator(rt－PA)incardiogeniccerebralemＧbolism．MethodsWerespectivelyreviewedthepatientswithcardiogeniccerebralembolisminourhospital．Fifty－ninesubjectswereenrolledandthirty－fourofthemwerethrombolyticgroupandtheothertwenty－fivepatientswerenon－thrombolyticgroup．Theneurologicaldeficits,andtheincidenceoffavorableoutＧcomeonthebaseline,２４thhour,７thdayand９０thdaywerecompared．Theincidenceofhemorrhagictransformation(HT)andmortalitywithin９０dayswereanＧalyzed．ResultsTherewasnosignificantdifferenceintheNationalInstitutesofHealthStrokeScale(NIHSS)scoreandModifiedRankinScale(mRS)intheonＧset,２４thhour,７thday,and９０thdaybetweenbothgroups．However,theincidenceofearlyimprovementinthethrombolyticgroupsignificantlyincreasedcomＧparedwiththenon－thrombolyticgroup(p＝０．００７和０．０１)．At９０thday,theincidenceofgoodprognosisinthethrombolyticgroupisnosignificantincreasecomＧparedwiththenon－thrombolyticgroup(p＝１．００)．TheincidenceofHTat２４thhourwassignificantly(p＝０．０４)higherinthethrombolyticgroupthanthatinthenon－thrombolyticgroup,butthedifferencebecamenotsignificantat７thday(p＝０．５７)．Therewere１１and１０deathcasesinthethrombolyticandnonthrombolyticgroupswithin９０daysfromtheonset,respectively,andnosignificantdifferencewasobserved(p＝０．５４)．ConclusionThert－PAincreasedtheinＧcidenceofearlyimprovementinpatientswithcardiogeniccerebralembolismbutalsotheHT２４thhour．However,thereisnosignificantdifferenceoflong－termprognoKseisy,owvoerrdasllhemorrhagictransformationanddeathbetweenthetwogroups．Recombinanttissueplasminogenactivator;Cardiogeniccerebralembolism;Thrombolysis;Hemorrhagictransformation中图分类号R５４２．２文献标识码B文章编号１００８－６３１５(２０１５)１０－０３４０－０２
出版日期
2015年09月19日（中国期刊网平台首次上网日期，不代表论文的发表时间）
