临床神经病学杂志2026，Vol.39Issue(4)：264-268,5.
阿替普酶与替奈普酶对老年急性缺血性脑卒中的疗效及预后的比较
Comparison of the efficacy and prognosis of alteplase and tenecteplase in elderly patients with acute ischemic stroke
摘要
Abstract
Objective To compare the efficacy and prognosis of alteplase(rt-PA)and tenecteplase(TNK-tPA)in elderly patients with acute ischemic stroke(AIS).Methods Eighty-six elderly patients with AIS were randomly divided into the TNK-tPA group(n=43)and the rt-PA group(n=43).The key time indexes of thrombolysis[door-to-needle time(DNT),drug preparation and operation time],operation-related adverse events,clinical efficacy,neurological deficit,nerve factor expression[nerve growth factor(NGF),neuron-specific enolase(NSE),central nervous system specific protein β(S-100β)],overall neurological disability and complications after thrombolysis were compared between the two groups.Results There was no significant difference in clinical efficacy between the rt-PA group and the TNK-tPA group at 7 d after thrombolysis(P<0.05).Compared with those in the rt-PA group,there was no significant difference in NIHSS before thrombolysis in the TNK-tPA group(P>0.05),and the NIHSS scores at 1 h,24 h,7 d after thrombolysis and at discharge were significantly decreased(P<0.05-0.01).Compared with those in the rt-PA group,the serum NGF level in the TNK-tPA group was significantly increased at 7 d after thrombolysis,and the NSE and S-100β levels were significantly decreased(all P<0.001).There was a statistically significant difference in the incidence of procedure-related adverse events between the rt-PA group and the TNK-tPA group(t=4.195,P=0.041);there was no statistically significant difference in the incidence of complications after thrombolysis(t=1.124,P=0.289),and there was no statistically significant difference in the incidence of hemorrhage-related complications(χ2=0.816,P=0.366).Compared with those in the rt-PA group,DNT and drug preparation and operation time in the TNK-tPA group were significantly decreased(all P<0.05).Compared with those in the rt-PA group,there was no significant difference in mRS score before and 30 d after thrombolysis in the TNK-tPA group(all P>0.05),and the mRS score was significantly decreased at 90 d after thrombolysis(P<0.05).Conclusion TNK-tPA and rt-PA can achieve good clinical efficacy in the treatment of elderly AIS patients,but TNK-tPA treatment can better improve the prognosis of patients,and the operation is more convenient.关键词
急性缺血性脑卒中/替奈普酶/阿替普酶/溶栓效率/预后Key words
acute ischemic stroke/tenecteplase/alteplase/thrombolytic efficiency/prognosis分类
医药卫生引用本文复制引用
孟燕,庞玉明,刘婷婷,王玮玮,魏玉清..阿替普酶与替奈普酶对老年急性缺血性脑卒中的疗效及预后的比较[J].临床神经病学杂志,2026,39(4):264-268,5.基金项目
邢台市重点研发计划自筹项目(2025ZC357) （2025ZC357）
