| 沈立.急性缺血性脑卒中启用rt-PA静脉溶栓联合依达拉奉右莰醇治疗时机的探讨[J].浙江中西医结合杂志,2025,35(7): |
| 急性缺血性脑卒中启用rt-PA静脉溶栓联合依达拉奉右莰醇治疗时机的探讨 |
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| 投稿时间：2024-10-14 修订日期：2025-05-07 |
| DOI： |
| 中文关键词: 急性缺血性脑卒中 重组组织型纤溶酶原激活剂 依达拉奉右莰醇 静脉溶栓 |
| 英文关键词:Acute ischemic stroke Recombinant tissue plasminogen activator Edaravone dextrocamphenol Intravenous thrombolysis |
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| 中文摘要: |
| 【】 目的 探讨急性缺血性脑卒中(AIS)启用重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓联合依达拉奉右莰醇(ED)治疗时机。方法 选择我院2021年4月至2023年5月收治的启用rt-PA静脉溶栓治疗的148例AIS患者,按随机数字表法将其分为对照组(n=46)、即刻组(n=50)、晚期组(n=52)。对照组AIS患者给予rt-PA静脉溶栓,即刻组在启用rt-PA静脉溶栓治疗基础上即刻使用依达拉奉右莰醇,晚期组在rt-PA静脉溶栓治疗24h后联合使用依达拉奉右莰醇。对比分析三组患者临床疗效、预后及安全性。结果 对照组、即刻组及晚期组治疗总有效率分别为78.26%(36/46)、94.00(47/50)、79.31(46/58),即刻组治疗总有效率明显高于对照组及晚期组(P均<0.05)。治疗后90d 3组患者mRS评分均降低,且相比对照组、晚期组,即刻组mRS评分均降低更低(P<0.05)；治疗后90d 3组患者其BI评分均升高,且相比对照组、晚期组,即刻组BI评分更高(P<0.05)。对照组和晚期组患者术后24 h症状性颅内出血发生率、90 d死亡率均高于即刻组(P<0.05)；3组患者颅外系统并发症消化道出血、腹腔出血、肺部感染、急性心肌梗死发生率比较无统计学差异(P>0.05)。结论 rt-PA静脉溶栓联合使用依达拉奉右莰醇治疗AIS患者均可提高其疗效和安全性,改善患者预后,且rt-PA静脉溶栓后立即联合依达拉奉右莰醇治疗的疗效及安全性更高。 |
| 英文摘要: |
| Objective To explore the optimal timing of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in combination with Edaravone Dextrocamphenol (ED) for the management of acute ischemic stroke (AIS). Methods A total of 148 AIS patients who underwent rt-PA intravenous thrombolysis in our hospital from April 2021 to May 2023 were selected and divided into the control group (n=46), the immediate group (n=50), and the advanced group (n=52) by random number table . The AIS cases in control group were administered with rt-PA intravenous thrombolytic therapy alone. The immediate group received immediate combination treatment of Edaravone Dextrocamphorol on the basis of rt-PA intravenous thrombolytic therapy in the control group. The advanced group was offered Edaravone Dextrocamphorol 24 hours after rt-PA intravenous thrombolytic therapy implemented in the control group. The clinical efficacy, prognosis and safety among the three groups were compared and analyzed. Results The total effective rates of the control group, the immediate group, and the advanced group were 78.26% (36/46), 94.00% (47/50), and 79.31% (46/58). The effective rate of immediate group was higher compared with control group and the advanced group (P <0.05). The modified Rankin Scale (mRS) score and the Barthel Index Rating Scale (BI) score among the three groups before treatment was no notable difference(P>0.05). The mRS scores of the three groups all decreased 90 days after treatment, and the mRS score of the immediate group was lower compared with control group and the advanced group (P<0.05). After 90 days of treatment, the BI score of the three groups increased, and the BI score of the immediate group was higher compared with control group and the advanced group (P<0.05). The incidence of symptomatic intracranial hemorrhage at 24 hours after the operation and the mortality at 90 days in the control group and the advanced group were higher than those in the immediate group (P<0.05). The incidence of gastrointestinal hemorrhage, abdominal hemorrhage, pulmonary infection and acute myocardial infarction among the three groups was no significant difference (P>0.05). Conclusion A combination of rt-PA intravenous thrombolysis and Edaravone Dextrocamphorol can enhance the therapeutic efficacy and safety of AIS patients and improve the prognosis of patients. Moreover, the immediate combination of rt-PA intravenous thrombolysis with Edaravone Dextrocamphorol exhibits higher efficacy and safety. |
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