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目的比较不同年龄急性缺血性脑卒中(AIS)患者应用阿替普酶静脉溶栓治疗的临床疗效及预后。方法选取2015年4月—2017年5月皖南医学院弋矶山医院神经内科收治的AIS患者84例,根据患者年龄分为低龄组44例(≤60岁)和高龄组40例(61~85岁)。两组患者均给予注射用阿替普酶静脉溶栓治疗(0.9 g/kg),治疗1d后口服阿司匹林肠溶片100 mg/d,持续治疗3周。比较两组患者临床疗效、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分及改良Rankin量表(mRS)评分、溶栓治疗相关并发症发生情况。结果低龄组患者临床疗效优于高龄组(P<0.01)。治疗前两组患者NIHSS评分、mRS评分比较,差异无统计学意义(P>0.05);治疗后低龄组NIHSS评分、mRS评分低于高龄组(P<0.05)。高龄组患者溶栓治疗相关并发症发生率高于低龄组(P<0.05)。结论与高龄AIS患者相比,阿替普酶静脉溶栓治疗低龄AIS的患者临床疗效较好,对神经功能和预后的改善效果更佳,安全性更高。
Objective To compare the clinical efficacy and prognosis of intravenous thrombolysis with alteplase in patients with acute ischemic stroke (AIS) at different ages. Methods From April 2015 to May 2017, 84 AIS patients admitted to Yijishan Hospital of Wannan Medical College were divided into 44 cases (≤60 years old) and 40 cases (61 ~ 85 cases) year old). Both groups were given intravenous thrombolytic therapy (0.9 g / kg) for injection of aspirin. One day later, aspirin enteric-coated tablets (100 mg / d) were given orally for 3 weeks. The clinical efficacy of the two groups were compared. NIHSS score, modified Rankin scale (mRS) score, and the incidence of thrombolytic therapy-related complications before and after treatment were compared between the two groups. Results The clinical efficacy of the younger group was better than that of the senior group (P <0.01). There was no significant difference in NIHSS score and mRS score between the two groups before treatment (P> 0.05). NIHSS score and mRS score in the younger group were lower than those in the senior group after treatment (P <0.05). The incidence of complications associated with thrombolysis in the elderly group was higher than that in the younger age group (P <0.05). Conclusion Compared with elderly patients with AIS, the effect of intravenous thrombolytic therapy of ALT for younger AIS is better, and it has better effect on neurological function and prognosis and higher safety.