赖舒帆　朱钦辉

【摘要】 目的：觀察与分析高龄与非高龄急性脑梗死患者使用不同静脉溶栓药物治疗的效果。方法：选取2014年8月-2017年12月本院收治的急性脑梗死患者85例。根据不同年龄将其分为≥75岁的高龄组37例（观察组）和<75岁的非高龄组48例（对照组）；根据不同溶栓治疗方案将其分为阿替普酶组32例（观察组12例，对照组20例）和尿激酶组53例（观察组25例，对照组28例）。比较各组治疗效果及并发症。结果：不同年龄段治疗前后NIHSS评分改善情况、发病后3个月mRS评分、溶栓并发症发生率比较，差异均无统计学意义（P>0.05）；不同溶栓治疗方案治疗前后NIHSS评分改善情况、溶栓并发症发生率比较，差异均有统计学意义（P<0.05）；不同溶栓治疗方案发病后3个月mRS评分比较差异无统计学意义（P>0.05）。结论：采用阿替普酶溶栓治疗急性脑梗死患者的短期疗效较尿激酶好，但并发症较多，且对于远期生活质量改善无优势，高龄可能并非静脉溶栓效果及并发症的重要影响因素。

【关键词】 高龄； 急性脑梗死； 静脉溶栓； 疗效观察

Therapeutic Effect of Different Intravenous Thrombolytic Drugs for Elderly and Non-senile Patients with Acute Cerebral Infarction/LAI Shufan，ZHU Qinhui.//Medical Innovation of China，2018，15（16）：0-047

【Abstract】 Objective：To observe and analyze the effect of different intravenous thrombolytic drugs in elderly and non-senile patients with acute cerebral infarction.Method：A total of 85 patients with acute cerebral infarction from August 2014 to December 2017 in our hospital were selected.According to different age groups，they were divided into 37 cases of elderly group≥75 years old（observation group） and 48 cases of non-senile grouP<75 years old（control group）.According to different thrombolytic therapy，they were divided into 32 cases of Alteplase group（12 cases in observation group and 20 cases in control group） and 53 cases of Urokinase group（25 cases in observation group and 28 cases in control group）.The treatment effects and complications of each group were compared.Result：The improvement of NIHSS score before and after treatment，the mRS score of after onset 3 months，and the incidence of thrombolysis complications were compared between different age groups，the differences were not statistically significant（P>0.05）.The improvement of NIHSS score before and after treatment，and incidence of thrombolysis complications in different thrombolytic therapy groups was compared，the differences were statistically significant（P<0.05）.The mRS score of after onset 3 months in different thrombolytic therapy groups was compared，the differences were not statistically significant（P>0.05）.Conclusion：The short-term efficacy of Alteplase thrombolytic therapy in patients with acute cerebral infarction is better than that of Urokinase，but there are many complications and no advantage in improving long-term quality of life，and advanced age may not be an important factor affecting the efficacy of intravenous thrombolysis and complications.

【Key words】 Elderly； Acute cerebral infarction； Intravenous thrombolysis； Curative effect observation

First-authors address：Meizhou Peoples Hospital，Meizhou 514031，China

doi：10.3969/j.issn.1674-4985.2018.16.013

脑梗死具有较高发病率、致残率、致死率，因而对老年人生命健康存在严重威胁。而临床针对急性脑梗死患者，主要采取的治疗方案为溶栓治疗，且能达到一定疗效[1-6]。因此本文即对高龄与非高龄急性脑梗死患者使用不同静脉溶栓药物治疗的效果进行了研究与分析，现报道如下。

1 资料与方法

1.1 一般资料 选取2014年8月-2017年12月本院收治的急性脑梗死患者85例，其中男55例，女30例；年龄54～86岁，平均（75.2±5.3）岁。纳入标准：发病6 h以内；无神经功能缺损对应的低密度区且头颅C排除颅内出血；瘫痪肢体肌力0～1级；临床表现神经功能缺损症状有诊断意义；患者及其家属均知晓同意。排除标准：严重肝肾功能不全；血小板计数<100×109/L；由出血倾向疾病史；颅内出血史。根据不同年龄将其分为≥75岁的高龄组37例（观察组）和<75岁的非高龄组48例（对照组）；再根据不同溶栓治疗方案将其分为阿替普酶组32例（观察组12例，对照组20例）和尿激酶组53例（观察组25例，对照组28例）。……