重组组织型纤溶酶原激活剂与依达拉奉联合应用治疗超早期脑梗死

目的 研究重组组织型纤溶酶原激活剂(rt-PA)与自由基清除剂依达拉奉联合治疗超早期脑梗死的疗效.方法 89例超早期脑梗死患者随机分为单独使用rt-PA溶栓治疗组(44例)和rt-PA溶栓联合自由基清除剂依达拉奉治疗组(45例),比较治疗30 d和90 d时的美国国立卫生院卒中量表评分(NIHSS)和Barthel指数(BI).结果 单纯溶栓组与联合治疗组溶栓治疗后30 d NIHSS评分0～1分的比例分别为25.0%(11/44)和35.6%(16/45),χ2=8.259,P=0.041;90 d时分别为27.3%(12/44)和40.0%(18/45),χ2=9.158,P=0.027.两组治疗后30 d时BI为95～100的比例分别为20.5%(9/44)和33.3%(15/45),χ2=8.833,P=0.032;90 d时分别为25.0%(11/44)和37.8%(17/45),χ2=8.221,P=0.042,即两组30 d和90 d的疗效差异有统计学意义.结论 超早期脑梗死治疗时rt-PA与依达拉奉联合能够更有效地减少治疗后30 d和90 d时的神经功能缺损.

Combined intravenous recombinant tissue plasminogen activator and edaravone for ultra-acute ischemic stroke

Objective To investigate the efficacy of combined intravenous rt-PA and free-radical scavengen (edaravone) on Chinese patients with acute ischemic stroke. Methods Eighty-nine subjects with ultra-acute ischemic stroke were assigned to the group treated with intravenous rt-PA and another group treated with a combination of intravenous rt-PA and edaravone. The NIH Stroke Scale (NIHSS) and Barthel Index (BI) in 30 days and 90 days after thrombolysis were compared between two groups. Results There were statistically significant differences between the group of rt-PA thrombolysis and the group of combined with rt-PA and edaravon in the ratio of NIHSS 0-1 of 30 days after therapy (25.0% vs35.6%, χ2=8.259,P=0.041) and 90 days (27.3%vs 40.0%, χ2=9.158,P=0.027),as well as in the proportion of BI 95-100 of the same time points(30 days:20.5%vs33.3%,χ2=8.833,P=0.032;90 days:25.O%vs37.8%,χ2=8.221,P=0.042).The rates of hemorrhagic conversion and mortality in two groups were similar. Conclusion rt-PA combined with free radical scavenger edaravone safely and effectively decreases the loss of neurofunctions and reserves more self-dependence capability in patients with acute ischemic stroke 30 days and 90 days after treatments.