中国卒中杂志2019，Vol.14Issue(3)：225-230,6.DOI:10.3969/j.issn.1673-5765.2019.03.006
丁苯酞联合阿替普酶治疗缺血性卒中临床疗效的观察性研究
The Effect of Butylphthalide Combined with Alteplase Thrombolysis in Patients with Ischemic Stroke
摘要
Abstract
Objective To investigate the clinical effect of butylphthalide in ischemic stroke patients with intravenous thrombolysis. Methods A retrospective analysis of 205 ischemic stroke patients treated by intravenous thrombolysis from Yantai Yuhuangding Hospital Affiliated to Qingdao University was performed. The patients were divided into combination group (n=112, rt-PA+butylphthalide) and rt-PA group (n=93). Clinical efficacy was assessed by the NIHSS scores immediately after thrombolysis, the NIHSS scores at 14 days after thrombolysis and the mRS scores at 90 days after thrombolysis. The difference in clinical efficacy among different TOAST subtypes were also analyzed. The safety outcome was evaluated by intracranial hemorrhage within 14 days and mortality at 90 days. The difference of clinical efficacy and safety between the two groups were compared. Results (1) There was no statistical difference in the NIHSS score immediately after thrombolysis between two groups. The NIHSS score at 14 days in combination group significantly decreased than that in rt-PA group [(4.82±0.44) vs (6.40±0.66), P=0.041]. The good prognosis (mRS≤2 score) rate at 90 days was higher in combination group than that in rt-PA group (72.3% vs 55.9%, P=0.014). Of all TOAST subgroups in combination group, the clinical efficacy (14-day NIHSS score and 90-day mRS score) in large-artery atherosclerosis (LAA) subgroup was best and significantly better than that in rt-PA group. (2) There were no statistical difference in safety outcome between the two groups. (3) Multiple-factor analysis showed butylphthalide was protective factor ( OR 0.425, 95% CI 0.216-0.835, P=0.013) for prognosis in ischemic stroke patients, and age >60 years ( OR 2.233, 95% CI 1.047-4.766, P=0.038), systolic blood pressure>160 mm Hg at admission (OR 2.295, 95% CI 1.126-4.679, P=0.022), and NIHSS score >10 before thrombolysis (OR 9.354, 95% CI 4.049-21.610, P<0.01) were independent risk factors for prognosis in stroke patients with intravenous thrombolysis. Conclusions Butylphthalide injection used in ischemic stroke patients with intravenous thrombolysis can further improved short-term prognosis comparing with only intravenous thrombolysis, especially in LAA subgroup.关键词
缺血性卒中/溶栓/预后/出血转化/丁苯酞Key words
Ischemic stroke/Thrombolysis/Outcome/Hemorrhagic transformation/Butylphthalide引用本文复制引用
HOU Yuan-Yuan,LIANG Zhi-Gang,SUN Xu-Wen,YANG Shao-Wan,LI Bing,HU Yin-Bao..丁苯酞联合阿替普酶治疗缺血性卒中临床疗效的观察性研究[J].中国卒中杂志,2019,14(3):225-230,6.基金项目
烟台市重点研发项目(2018SFGY092) （2018SFGY092）
