摘要
目的 探究重组组织型纤溶酶原激活物(rt-PA)静脉溶栓前抗血小板治疗对脑梗死患者溶栓效果及预后的影响.方法 回顾性分析2014年5月至2018年12月运城市中心医院神经内科收治的96例脑梗死患者的临床资料,根据其rt-PA溶栓前是否应用抗血小板治疗分为两组,对照组48例仅行溶栓治疗,研究组48例于rt-PA溶栓前行抗血小板治疗.观察两组患者的溶栓效果、预后情况以及安全性.结果 经rt-PA溶栓治疗后,研究组溶栓后24 h、7 d的溶栓效果良好率(66.67%、70.83%)高于对照组(45.83%、50.00%),差异有统计学意义(P<0.05);溶栓治疗后90 d,对照组与研究组预后良好率(79.17%比83.33%)比较差异未见统计学意义(P>0.05);溶栓治疗后90 d内,对照组与研究组非症状性颅内出血发生率(8.33%比4.17%)、症状性颅内出血发生率(6.25%比4.17%)及病死率(4.17%比2.08%)比较,差异未见统计学意义(P>0.05).结论 rt-PA溶栓治疗前进行抗血小板治疗有助于提高脑梗死患者的近期溶栓治疗效果,对患者远期预后无明显影响,不会增加患者颅内出血发生风险及死亡风险,具有安全性.
Objective To investigate the effects of antiplatelet therapy before intravenous thrombolysis of recombinant tissue plasminogen activator(rt-PA)on thrombolytic effects and prognosis in patients with cerebral infarction.Methods The clinical data of 96 patients with cerebral infarction admitted to Department of Neurology of Yuncheng Central Hospital from May 2014 to December 2018 were retrospectively analyzed.All the patients were divided into two groups according to whether antiplatelet therapy was used before rt-PA thrombolysis for them.Forty-eight cases in the control group received thrombolytic therapy only,and 48 cases in the study group received antiplatelet therapy before rt-PA thrombolytic therapy.The thrombolytic effects,prognosis and safety of the two groups were observed.Results After rt-PA thrombolysis treatment,the good rates of thrombolysis 24 hours and 7 days after thrombolysis in the study group(66.67%and 70.83%)were higher than those in the control group(45.83%and 50.00%),and the difference was statistically significant(P<0.05).There was no significant difference in the good prognosis rate between the control group(79.17%)and the study group(83.33%)90 days after treatment(P>0.05).Within 90 days after thrombolytic therapy,there was no significant difference in the incidence of asymptomatic intracranial hemorrhage(8.33%vs.4.17%),the incidence of symptomatic intracranial hemorrhage(6.25%vs.4.17%)and the mortality rate(4.17%vs.2.08%)between the control group and the study group(P>0.05).Conclusions Antiplatelet therapy before rt-PA thrombolysis can improve the recent thrombolytic effects in patients with cerebral infarction.And it has no significant effect on the long-term prognosis,without increase in the risk of intracranial hemorrhage and the risk of mortality,so it has safety.
作者
刘晓玲
Liu Xiaoling(Department of Neurology,Yuncheng Central Hospital,Yuncheng 044000,China)
出处
《中国实用医刊》
2019年第19期72-75,共4页
Chinese Journal of Practical Medicine
关键词
重组组织型纤溶酶原激活物
溶栓
抗血小板治疗
脑梗死
Recombinant tissue plasminogen activator
Thrombolysis
Antiplatelet therapy
Cerebral infarction
