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目的探讨阿替普酶(rt-PA)静脉溶栓治疗急性脑梗死(ACI)的临床疗效和安全性。方法选择4.5h内的ACI患者64例分别采用rt-PA 0.6mg/kg(最大剂量为60mg)(A组,30例)和rt-PA 0.9mg/kg(最大剂量为90mg)(B组,34例)。治疗后24h、7、28和90d用NIHSS量表评估疗效;比较治疗前和治疗后90d的改良Rankin评分和日常生活(ADL)量表评分;以治疗期间颅内出血发生率和90d内病死率评估安全性。结果两组治疗后NIHSS评分均比治疗前明显改善(P<0.01)。90d内颅内出血:A组2例(6.6%),B组4例(11.7%)。90d内死亡:A组1例(3.3%),B组3例(8.8%)。结论应用低剂量静脉溶栓治疗发病4.5h内的ACI有效、安全。
Objective To investigate the clinical efficacy and safety of intravenous infusion of rt-PA in acute cerebral infarction (ACI). METHODS: Sixty-four patients with ACI within 4.5 h were treated with rt-PA 0.6 mg / kg (maximal dose 60 mg) (group A, 30) and rt-PA 0.9 mg / kg 34 cases). The therapeutic effect was evaluated by NIHSS scale at 24h, 7th, 28th and 90th day after treatment. The modified Rankin score and daily life (ADL) score were compared before and 90 days after treatment. The intracranial hemorrhage rate and mortality within 90d safety. Results The NIHSS scores of both groups were significantly improved after treatment (P <0.01). Intracranial hemorrhage within 90 days: A group 2 cases (6.6%), B group 4 cases (11.7%). One death occurred in 90 days in group A (3.3%) and three cases in group B (8.8%). Conclusion Low-dose intravenous thrombolysis is effective and safe in treating ACI within 4.5 hours.