重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中伴糖尿病患者疗效观察.docVIP

重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中伴糖尿病患者疗效观察 　　【摘要】 目的：探讨重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中伴糖尿病患者的疗效。方法：选取本院2010年1月-2014年1月收治的发病4.5 h以内急性缺血性脑卒中患者198例，根据有无伴糖尿病分为糖尿病组（100例）和非糖尿病组（98例），两组均给予重组组织型纤溶酶原激活剂静脉溶栓治疗，采用rt-PA 0.9 mg/kg（最大剂量为90 mg），先1 min静脉注射10%剂量，剩余的90%剂量溶于100 mL生理盐水1 h内静脉滴注。记录两组溶栓前、溶栓后24 h、7 d的神经功能缺损评分（NIHSS）和21 d后日常生活能力量表Barthel Index量表评分。比较两组患者治疗的总有效率、并发症的发生率及死亡率。结果：溶栓前，两组NIHSS评分比较差异无统计学意义（P0.05）；溶栓后24 h和7 d，非糖尿病组NIHSS评分明显低于糖尿病组，差异具有统计学意义（P0.05）。结论：rt-PA静脉溶栓治疗急性缺血性脑卒中伴糖尿病患者取得一定的治疗效果，但糖尿病是影响急性缺血性脑卒中预后的因素，糖尿病并不增加rt-PA溶栓后继发性出血的可能性。 　　【关键词】 重组组织型纤维酶原激活剂； 静脉溶栓； 急性缺血性脑卒中； 糖尿病； 疗效 　　Curative Effect of Intravenous Thrombolytic Therapy with Recombinant Tissue Plasminogen Activator on Acute Cerebral Infarction with Diabetes Mellitus/ZHANG Feng-ju.//Medical Innovation of China，2015，12（24）：053-055 　　【Abstract】 Objective：To explore the curative effect of intravenous thrombolytic therapy with recombinant tissue plasminogen activator on acute cerebral infarction with diabetes mellitus.Method： One hundred and ninty-eight patients undergoing acute cerebral infarction admitted to our hospital from January 2010 to January 2014 were chosen and divided into diabetes mellitus group （100 cases） and non-diabetes mellitus group （98 cases）， which was based on whether the patients suffer from diabetes mellitus. Both groups were given rt-PA intravenous thrombolytic therapy. Scores of the national institutes of health stroke scale （NIHSS） were recorded pre-therapy， 24 hours and 7 days post-therapy. Barthel Index scores were recorded 21 days after therapy. The total efficiency， occurrence of complication and death rate of the two groups were compared. Result： Before treatment，the NIHSS scores were no statistical significance between two groups（P0.05）；the NIHSS scores of non-diabetes mellitus group were significantly lower than those of diabetes mellitus group at 24 hours and 7 days post-therapy （P0.05）.Conclusion：Diabetes mellitus can affect the curative effect of intravenous thrombolytic therap