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阿替普酶溶栓对缺血性脑卒中患者凝血功能及神经功能的影响

Effect of Alteplase Thrombolysis on Coagulation Function and Nerve Function of Patients with Ischemic Stroke.

作者信息

Zhao Hong-Ying, Yang Guo-Tao, Zhang Hui-Fang, Wang Wen-Hao

机构信息

Department of Geriatrics, Cangzhou Central Hospital, Cangzhou 061000, Hebei, China.

Department of Neurology, Cangzhou Central Hospital, Cangzhou 061000, Hebei, China.

出版信息

Evid Based Complement Alternat Med. 2022 May 9;2022:9440271. doi: 10.1155/2022/9440271. eCollection 2022.

Abstract

OBJECTIVE

To investigate the effects of alteplase thrombolysis on coagulation function and nerve function of patients with ischemic stroke.

METHODS

76 cases with ischemic stroke receiving thrombolytic therapy in Cangzhou Central Hospital from November 2018 to November 2019 were recruited. They were assigned via the random number table method at a ratio of 1 : 1 to receive alteplase thrombolysis either within 3h after the onset (observation group) or within 3-4.5 h after the onset (control group), followed by aspirin administration after no bleeding in cranial computed tomography (CT). Outcome measures included plasma fibrinogen (FIB), activated partial prothrombin time (APTT), platelet (PLT) levels, the National Institute of Health stroke scale (NIHSS) score, and adverse events.

RESULTS

Alteplase thrombolysis within 3 h was associated with better prothrombin time (PT), APTT, FIB, and PLT levels versus thrombolysis within 3-4.5 h ( < 0.05). Thrombolysis within 3 h showed significantly lower NIHSS scores versus within 3-4.5 h ( < 0.05). The two groups showed a similar incidence of adverse events (  = 2.963, =0.615).

CONCLUSION

Alteplase thrombolysis showed benefits in mitigating the coagulation function and nerve function damage of patients with ischemic stroke, especially within 3 hours after the onset, with a high safety profile.

摘要

目的

探讨阿替普酶溶栓对缺血性脑卒中患者凝血功能及神经功能的影响。

方法

选取2018年11月至2019年11月在沧州市中心医院接受溶栓治疗的76例缺血性脑卒中患者。通过随机数字表法将其按1∶1比例分为两组,分别在发病后3小时内(观察组)或发病后3 - 4.5小时内(对照组)接受阿替普酶溶栓治疗,头颅计算机断层扫描(CT)无出血后给予阿司匹林治疗。观察指标包括血浆纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、血小板(PLT)水平、美国国立卫生研究院卒中量表(NIHSS)评分及不良事件。

结果

与发病后3 - 4.5小时内溶栓相比,发病后3小时内进行阿替普酶溶栓的患者凝血酶原时间(PT)、APTT、FIB及PLT水平更佳(P < 0.05)。发病后3小时内溶栓的患者NIHSS评分显著低于发病后3 - 4.5小时内溶栓的患者(P < 0.05)。两组不良事件发生率相似(χ² = 2.963,P = 0.615)。

结论

阿替普酶溶栓有助于减轻缺血性脑卒中患者的凝血功能及神经功能损伤,尤其是在发病后3小时内,安全性高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234a/9110162/cac9e0c0e1fb/ECAM2022-9440271.001.jpg

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