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[摘要]
目的 探讨注射用丹参多酚酸联合注射用阿替普酶静脉溶栓治疗急性脑梗死的安全性及临床疗效。方法 选取太原钢铁(集团)有限公司总医院神经内科于2017年3月——2018年3月收治的急性缺血性脑卒中患者92例,分为对照组及观察组。对照组42例,给予静脉溶栓治疗,10%注射用阿替普酶(0.9 mg/kg)静推,其余90%在1 h内静点完毕,随后静脉滴注生理盐水250 mL;24 h后给予缺血性卒中的基础用药。观察组50例,在相同方法静脉溶栓后立刻给予注射用丹参多酚酸0.13 g加入250 mL生理盐水中,静脉滴注,1次/d,连续用药14 d;溶栓24 h后给予缺血性卒中的基础用药。所有入选患者分别于治疗前、治疗后14、90 d记录美国国立卫生研究院卒中量表(NIHSS)评分、Barthel(BI)指数、改良Rankin量表(mRS)评分并记录不良反应事件。结果 治疗前,对照组、观察组的NIHSS评分、mRS评分、BI指数未见显著差异。与治疗前比较,用药后14、90 d,对照组、观察组的NIHSS评分、mRS评分均显著下降,BI指数显著升高(P<0.05);用药后14 d,两组患者的NIHSS评分、mRS评分、BI指数未见显著差异;用药后90 d,观察组的NIHSS评分、mRS评分较对照组显著降低,BI指数显著升高(P<0.05)。两组患者用药后均未出现颅内出血。结论 注射用丹参多酚酸联合注射用阿替普酶静脉溶栓治疗急性脑梗死患者安全性高,且明显改善患者预后。
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[Abstract]
Objective To study the safety and clinical efficacy of intravenous thrombolysis with Salvianolic Acids for Injection and Alteplase for Injection in the treatment of acute cerebral infarction. Methods 92 patients with acute cerebral infarction were selected and divided into control group and experimental group. 42 cases in control group were given rt-PA therapy with atenopramide for 24 hours, and 50 cases in experimental group were given SAFI 100 mg + 0.9% sodium chloride 250 mL immediately after intravenous thrombolysis with the same method, once a day for 14 days, followed by ischemia 24 hours after thrombolysis. Basic drugs for stroke. The National Institutes of Health Stroke Scale (NIHSS), Activity of Daily Living (BI), Modified Rankin Scale (mRS) and adverse events were recorded before and 14 and 90 days after treatment. Results Before treatment, there were no significant differences in NIHSS score, mRS score and BI index between the control group and the observation group. Compared with before treatment, NIHSS score and mRS score of control group and observation group decreased significantly and BI index increased significantly at 14 and 90 days after treatment (P<0.05); NIHSS score, mRS score and BI index of two groups had no significant difference at 14 days after treatment; NIHSS score and mRS score of observation group decreased significantly and BI index increased significantly at 90 days after treatment compared with control group (P<0.05). There was no intracranial hemorrhage in both groups. Conclusion Intravenous thrombolysis with SAFI and rt-PA is safe and can improve the prognosis of patients with acute cerebral infarction.
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