TOAST分型rt—PA静脉溶栓治疗超早期脑梗死的效果研究(1)
摘 要：目的 评价超早期脑梗死TOAST分型rt-PA静脉溶栓治疗的有效性和安全性。方法 选取静海区医院收治的急性脑梗死患者129例，将所有脑梗死患者根据TOAST分型划分为LAA组、CE组、SAO组及SOE+SUE组共四组，所选患者均为发病时间在4.5 h内，行规范性rt-PA静脉溶栓治疗，对比分析其临床效果和治疗的不良反应。结果 LAA组、CE组、SAO组、SOE+SUE组溶栓治疗前后NIHSS评分下降，差异有统计学意义(P<0.05)；溶栓治疗后各组NIHSS评分比较，SAO组低于LAA组、CE组、SOE+SUE组，差异有统计学意义(P<0.05)；CE组不良反应发生率高于LAA组、SAO组、SOE+SUE组，差异有统计学意义(P<0.05)。结论 超早期脑梗死4.5 h内行rt-PA静脉溶栓治疗不同TOAST分型脑梗死患者均可获益，且SAO型效果最佳；针对于CE患者应注意病情变化，降低其出血发生率。
关键词：TOAST分 型；超早期脑梗死；rt-PA静脉溶栓；NIHSS评分
, 百拇医药
中圖分类号：R743 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.022
文章编号：1006-1959(2018)08-0072-03
Study on the Effect of Intravenous Thrombolytic Therapy with TOAST Type rt-PA in the Treatment of Super Early Cerebral Infarction
ZHAO Shu-xia
(Department of Neurology，Tianjin Jinghai District Hospital，Tianjin 301600，China)
Abstract：Objective To evaluate the efficacy and safety of TOAST classification rt-PA intravenous thrombolytic therapy for super early cerebral infarction.Methods 129 patients with acute cerebral infarction treated in Jinghai District Hospital were divided into four groups according to TOAST classification：LAA group，CE group，SAO group and SOE+SUE group.All the patients were treated with rt-PA intravenous thrombolytic therapy within 4.5 h.The clinical effect and adverse reaction of the treatment were compared and analyzed.Results The NIHSS scores of LAA group，CE group，SAO group，SOE+SUE group before and after thrombolytic therapy were significantly decreased，the difference was statistically significant(P<0.05)；After thrombolytic treatment，the scores of NIHSS in group SAO were lower than that in group LAA，group CE and SOE+SUE group，the difference was statistically significant(P<0.05)，and the incidence of adverse reactions in group CE was higher than that in group LAA，SAO and SOE+SUE group，and the difference was statistically significant(P<0.05).Conclusion The 4.5h rt-PA intravenous thrombolytic therapy in the ultra early cerebral infarction can benefit from the different TOAST type cerebral infarction patients，and the SAO type effect is the best.For the patients with CE，we should pay attention to the change of the disease and reduce the incidence of bleeding.
, 百拇医药
Key words：TOAST classification；Super early cerebral infarction；rt-PA intravenous thrombolysis；NIHSS score.
脑梗死又称缺血性脑卒中(cerebralischemicstroke)，是指因脑部血液供应障碍，缺血、缺氧所导致的局限性脑组织的缺血性坏死或软化，约占全部脑卒中的60%～80%，其发病率逐年上升，具有高发病率、高致残率、高病死率等特点，严重威胁着人类的健康和生存。因此，积极治疗脑梗死，有利于改善患者预后，降低其死亡率。目前，临床公认治疗超早期脑梗死有效的方法是rt-PA静脉溶栓[1]，它可以使闭塞血管部分或完全再通，改善血流，促使神经功能恢复。但对于不同TOAST分型的超早期脑梗死患者，rt-PA静脉溶栓治疗的有效性和安全性存在一定的差异。本次选取天津静海区医院77例超早期脑梗死患者通过TOAST分型，并全部实施rt-PA静脉溶栓，获得TOAST分型脑梗死患者和静脉溶栓效果的相关性，现报道如下。, http://www.100md.com(赵淑霞)
关键词：TOAST分 型；超早期脑梗死；rt-PA静脉溶栓；NIHSS评分
, 百拇医药
中圖分类号：R743 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.022
文章编号：1006-1959(2018)08-0072-03
Study on the Effect of Intravenous Thrombolytic Therapy with TOAST Type rt-PA in the Treatment of Super Early Cerebral Infarction
ZHAO Shu-xia
(Department of Neurology，Tianjin Jinghai District Hospital，Tianjin 301600，China)
Abstract：Objective To evaluate the efficacy and safety of TOAST classification rt-PA intravenous thrombolytic therapy for super early cerebral infarction.Methods 129 patients with acute cerebral infarction treated in Jinghai District Hospital were divided into four groups according to TOAST classification：LAA group，CE group，SAO group and SOE+SUE group.All the patients were treated with rt-PA intravenous thrombolytic therapy within 4.5 h.The clinical effect and adverse reaction of the treatment were compared and analyzed.Results The NIHSS scores of LAA group，CE group，SAO group，SOE+SUE group before and after thrombolytic therapy were significantly decreased，the difference was statistically significant(P<0.05)；After thrombolytic treatment，the scores of NIHSS in group SAO were lower than that in group LAA，group CE and SOE+SUE group，the difference was statistically significant(P<0.05)，and the incidence of adverse reactions in group CE was higher than that in group LAA，SAO and SOE+SUE group，and the difference was statistically significant(P<0.05).Conclusion The 4.5h rt-PA intravenous thrombolytic therapy in the ultra early cerebral infarction can benefit from the different TOAST type cerebral infarction patients，and the SAO type effect is the best.For the patients with CE，we should pay attention to the change of the disease and reduce the incidence of bleeding.
, 百拇医药
Key words：TOAST classification；Super early cerebral infarction；rt-PA intravenous thrombolysis；NIHSS score.
脑梗死又称缺血性脑卒中(cerebralischemicstroke)，是指因脑部血液供应障碍，缺血、缺氧所导致的局限性脑组织的缺血性坏死或软化，约占全部脑卒中的60%～80%，其发病率逐年上升，具有高发病率、高致残率、高病死率等特点，严重威胁着人类的健康和生存。因此，积极治疗脑梗死，有利于改善患者预后，降低其死亡率。目前，临床公认治疗超早期脑梗死有效的方法是rt-PA静脉溶栓[1]，它可以使闭塞血管部分或完全再通，改善血流，促使神经功能恢复。但对于不同TOAST分型的超早期脑梗死患者，rt-PA静脉溶栓治疗的有效性和安全性存在一定的差异。本次选取天津静海区医院77例超早期脑梗死患者通过TOAST分型，并全部实施rt-PA静脉溶栓，获得TOAST分型脑梗死患者和静脉溶栓效果的相关性，现报道如下。, http://www.100md.com(赵淑霞)