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目的观察重组人组织型纤溶酶原激酶衍生物(Reteplase,rPA)治疗急性期脑梗死的疗效。方法42例急性脑梗死患者,符中国脑血管防治指南规定的溶栓条件,NIHSS≥4分,用rPA36~54 mg行静脉溶栓治疗,观察入院时及治疗7 d后神经功能缺损评分(NIHSS)和临床疗效。结果 (1)标准剂量rPA对凝血功能影响较低剂量组大,特别是对活化部分凝血酶时间(activated partial thromboplastin time,APTT)的影响;(2)rPA溶栓安全有效,症状性脑出血(symptomatic intracerebral hemorrhage,SICH)发生与APTT异常有关;(3)4.5~6 h使用rPA与SICH无关。结论 rPA治疗急性期脑梗死安全有效,但应注意凝血功能,尤其是APTT的异常。
Objective To observe the therapeutic effect of recombinant human tissue plasminogen kinase (rPA) on acute cerebral infarction. Methods Forty-two patients with acute cerebral infarction were enrolled in the Guidelines for Prevention and Treatment of Cerebrovascular Disease in China. NIHSS≥4 points and rPA36 ~ 54 mg intravenous thrombolysis. The neurological deficit score (NIHSS ) And clinical efficacy. Results (1) The effect of standard dose of rPA on coagulation function was lower than that in the lower dose group, especially the activated partial thromboplastin time (APTT). (2) The rPA thrombolysis was safe and effective, and symptomatic intracerebral hemorrhage symptomatic intracerebral hemorrhage (SICH) was associated with abnormal APTT. (3) 4.5-5 h had no correlation with SICH. Conclusions rPA is safe and effective in the treatment of acute cerebral infarction. However, coagulation, especially APTT, should be noted.