重组组织型纤溶酶原激活剂早期静脉溶栓治疗急性脑梗死

[Early intravenous thrombolysis with recombinant tissue plasminogen activator for acute cerebral infarction].

作者信息

Wang Shen-yan, Wang Xue-lihong, Zeng Hong, Zuo Ying, Hu Nan, Li Xue-ying, Huang Fei, Yu Hai-ling, Wang Hong-yuan

机构信息

Emergency Department, Beijing Emergency Medical Center, Beijing 100031, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2003 Sep;15(9):542-5.

PMID:12971850

Abstract

OBJECTIVE

To evaluate the efficacy and safety of recombinant tissue plasminogen activator (rt-PA) and to explore the most suitable dosage of rt-PA in the early treatment of the Chinese patients with acute cerebral infarction (ACI).

METHODS

The patients who suited for the standard were divided into three groups. Group A received rt-PA at 0.9 mg/kg, group B received rt-PA at 0.7 mg/kg, and group C did not receive any thrombolytic therapy. In thrombolytic groups, rt-PA at 8 mg was injected intravenously in a bolus at first and then the rest was given over 60 minutes. The maximal dosage was 90 mg. The Chinese stroke scale (CSS) and Barthel Index (BI) were used to evaluate the recovery of neurological functions after rt-PA treatment for 24 hours and 90 days. The hemorrhagic rate and 30 days mortality rate were also analysed.

RESULTS

In group A the CSS significant effective rate was 41.18 percent at 24 hours and 76.47 percent at 90 days after thrombolysis. At 90 days BI significant effective rate was 58.82 percent. At 30 days hemorrhagic rate was 8.82 percent and mortality rate was 5.88 percent. In group B, the CSS significant effective rate was 39.39 percent at 24 hours and 69.70 percent at 90 days. At 90 days, BI significant effective rate was 54.55 percent, and at 30 days, hemorrhagic rate was 9.09 percent and mortality rate was 9.09 percent. In group C, the CSS significant effective rate was 21.21 percent, at 24 hours and 30.30 percent at 90 days (P>0.05). At 90 days, BI was 21.21 percent the mortality rate was 9.09 percent. At 30 days the mortality rate was no significant difference within three groups At 90 days, significant effective rate was 73.13 percent vs. 30.30 percent in thrombolytic and control groups (P=0.001 7). The significant disability rate was 13.43 percent vs. 24.24 percent.

CONCLUSION

For Chinese individuals, with ACI, rt-PA thrombolysis was effective and safe. The dosage of 0.9 mg/kg for foreign people also fitted for Chinese individuals.

摘要

目的

评估重组组织型纤溶酶原激活剂（rt-PA）治疗中国急性脑梗死（ACI）患者的疗效和安全性，并探索rt-PA的最适剂量。

方法

符合标准的患者分为三组。A组接受0.9mg/kg的rt-PA治疗，B组接受0.7mg/kg的rt-PA治疗，C组未接受任何溶栓治疗。在溶栓组中，先静脉推注8mg rt-PA，然后其余剂量在60分钟内输注完毕。最大剂量为90mg。采用中国卒中量表（CSS）和Barthel指数（BI）评估rt-PA治疗24小时和90天后神经功能的恢复情况。同时分析出血率和30天死亡率。

结果

A组溶栓后24小时CSS显著有效率为41.18%，90天为76.47%。90天时BI显著有效率为58.82%。30天时出血率为8.82%，死亡率为5.88%。B组溶栓后24小时CSS显著有效率为39.39%，90天为69.70%。90天时，BI显著有效率为54.55%，30天时，出血率为9.09%，死亡率为9.09%。C组溶栓后24小时CSS显著有效率为21.21%，90天为30.30%（P>0.05）。90天时，BI为21.21%，死亡率为9.09%。30天时三组死亡率无显著差异。90天时，溶栓组与对照组显著有效率分别为73.13%和30.30%（P=0.0017）。显著残疾率分别为13.43%和24.24%。