短暂性脑缺血发作溶栓治疗的早期疗效与ABCD~2评分的关系Therapeutic effect of thrombolysis on patients with transient ischemic attack and relationship with ABCD~2 score
王孝良;许玉华;
摘要(Abstract):
目的观察小剂量尿激酶溶栓治疗对短暂性脑缺血发作(TIA)的早期疗效和安全性,并探讨ABCD2评分与溶栓治疗效果的关系。方法 40例接受溶栓治疗的TIA患者为观察组,给予50万U尿激酶溶栓治疗,观察治疗后1周TIA发作次数、急性脑梗死和出血性疾病发生率,并与40例未溶栓治疗的TIA患者对照分析。采用ABCD2评分法将患者分为低危组、中危组和高危组,比较各亚组疗效差异。结果观察组TIA发作次数为(1.16±0.34)次,急性脑梗死发生率为2.5%,均显著低于对照组的(3.42±1.86)次和15%(P<0.05),而出血性疾病发生率比较差异无统计学意义(P>0.05)。观察组各亚组间TIA发作次数和急性脑梗死发生率比较差异均无统计学意义(P>0.05),而对照组内随危险度升高,TIA发作次数明显增加(F=10.406,P<0.05),且高危组急性脑梗死发生率显著高于低危和中危组(χ2=8.550,P<0.05)。结论 TIA患者早期溶栓治疗能减少发作次数,降低急性脑梗死风险,尤其是对于高危患者,疗效更为显著。
关键词(KeyWords): 短暂性脑缺血发作;尿激酶;溶栓治疗;ABCD2评分
基金项目(Foundation):
作者(Author): 王孝良;许玉华;
Email:
DOI: 10.14053/j.cnki.ppcr.2014.03.032
参考文献(References):
- [1]Ghandehari K,Ahmadi F,Ebrahimzadeh S,et al.Assessment of ABCD2scale in patients with transient ischaemic attack or stroke[J].Neurol Neurochir Pol,2012,46(5):421-427.
- [2]Sanders LM,Srikanth VK,Blacker DJ,et al.Performance of the ABCD2score for stroke risk post TIA:meta-analysis and probability modeling[J].Neurology,2012,79(10):971-980.
- [3]李津金,芮庆林.小剂量尿激酶治疗短暂性脑缺血发作的系统评价[J].中国急救医学,2011,31(4):343-347.
- [4]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379.
- [5]谢康,崔煜,郑重,等.尿激酶治疗频发短暂性脑缺血发作临床研究[J].中华全科医学,2009,7(1):1-20.
- [6]Heldner MR,Arnold M,Gralla J,Management of transient ischemic attack(TIA)and acute stroke[J].Praxis,2012,101(6):389-397.
- [7]Jolobe OM.Better characterization of transient ischemic attack might improve the benefit:risk profile ofthrombolysis[J].J Am Geriatr Soc,2012,60(3):598.
- [8]谷伟中.低分子肝素钠联合阿司匹林肠溶片治疗短暂性脑缺血发作的疗效及安全性[J].中国医药,2012,7(10):1232-1233.
- [9]吴杰贤,姚晓黎.小剂量尿激酶治疗短暂性脑缺血发作的疗效观察[J].中国实用神经疾病杂志,2011,14(5):76-77.
- [10]袁亮方,姜国晶,张红,等.小剂量尿激酶治疗频发短暂性脑缺血发作的临床研究[J].吉林医学,2010,31(7):891-892.
- [11]Easton JD,Saver JL,Albers GW,et al.Definition and evaluation of transient ischemic attack:a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council;Council on Cardiovascular Surgery and Anesthesia;Council on Cardiovascular Radiology and Intervention;Council on Cardiovascular Nursing;and the Interdisciplinary Council on Peripheral Vascular Disease.The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists[J].Stroke,2009,40(1):2276-2293.
- [12]葛建新,张祺斌.使用ABCD2评分评估短暂性脑缺血发作患者发生脑梗死的风险[J].中国医师杂志,2013,15(6):842-844.