简介:目的探讨重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗急性脑梗死的临床疗效。方法69例发病在4.5小时内具有溶栓指征的急性脑梗死患者,其中观察组37例行rt-PA静脉溶栓,对照组32例行常规抗血小板治疗。以美国国立卫生院卒中量表(NIHSS)评分评定溶栓后临床疗效,以Barthel指数(BI)评分及改良Rankin量表(mRS)评分判断治疗后90d生活质量及预后。结果观察组治疗后2h、24h、7dNIHSS评分显著低于对照组[(9.23±3.51)vs(11.32±1.12),(6.72±2.31)vs(9.24±2.53),(4.23±2.12)vs(7.34±1.43)],差异有统计学意义(P〈0.05);治疗后90天BI评分观察组显著高于对照组[(78.56±3.51)vs(61.30±4.13)],差异有统计学意义(P〈0.05);治疗后90天mRS评分疗效良好率观察组显著高于对照组[67.56%(25/37)vs34.38%(11/32)],差异有统计学意义(P〈0.01)。观察组24h脑出血率及死亡率高于对照组[16.21%(6/37)vs9.37%(3/32)],但差异无统计学意义(P〉0.05)。结论时间窗内rt-PA静脉溶栓治疗急性脑梗死近、远期疗效均较常规抗血小板治疗显著。
简介:BackgroundTheregulationoft-PAgeneistheessenceandcoreofthrombosis.Therefore,thepresentstudyaimedtopreparenanot-PAgenecoatedstentandtoobserveitseffectoncoronarystentthrombosisindogs.MethodsHighlyexpressedt-PAgeneplasmidwasconstructedandalbuminnanot-PAgenecoatingstentwasprepared.Themajorbranchvesselsofdogcoronaryarterywerepre-expandedwitha3.0mm×20balloonwith8-10atmosphericpressure.10dogsofthecontrolgroupwereimplantedwithbaremetalstent;while12dogsoftheexperimentalgroupwereimplantedwithnanot-PAgenecoatingstent.Bothgroupswerenotgivenanti-coagulationtreatments.Bloodsamplesweretakenfort-PAandD-dimerbeforetheoperation,at1,2,4and8weeksafteroperation.Pathologicalanalysisfoundthrombosisinthecavityandthehyperplasiaoftheintima.t-PAexpressionwasdetectedbyimmunohistochemicalindirectly,andthethicknessoftheintimaofthesectioncrosswasdirectlymeasuredbymorphometry.Liver,heart,kidneysandlungweretakenforpathologicalobservation.ResultsAllexperimentalanimalssurvivedatpostoperative8weeks.Vascularstentthrombosiswasseenin10casesofthecontrolgroupwiththethrombosisrateof100%;whilewasseenin2casesamong12casesoftheexperimentalgroupwiththethrombosisratewas16.67%(P=0.00087).Immunohistochemicalstainingshowedthatthepositivet-PAgenetransfectionoftheexperimentalgroupwasmainlydistributedonthesurfaceofhyperplasiaintima,andvascularwallt-PAexpressionofthecontrolgroupwasnegative.Positivet-PAsignalwasnotfoundintheliver,heart,kidneysandlung.ConclusionNanot-PAgenevectorcoatingstentcaneffectivelyexpresst-PAinvascularwallandeffectivelypreventsstentthrombosis.
简介:目的研究rt-PA(重组人组织型纤溶酶原刺激活物)动脉溶栓联合机械取栓治疗46例急性脑栓塞患者的临床效果。方法以2016年1月~2017年1月在我院接受救治的急性脑栓塞患者为研究对象,均接受rt-PA动脉溶栓联合机械取栓治疗,评估患者治疗效果,对比其治疗前后神经功能及日常生活能力变化。结果本组患者治疗后病灶血管完全再通24例、部分再通17例、再通失败5例,血管再通率89.1%。患者治疗后NISS评分、ADL评分与治疗前相比均存在明显差异,对比存在统计学意义(P〈0.05)。本组患者治疗后出现脑出血3例、继发性脑梗死2例,并发症发生率10.9%。结论rt-PA动脉溶栓联合机械取栓治疗急性脑梗死患者效果显著,患者血管再通率高且神经功能缺损、生活自理能力均得到显著改善,值得推广。