发病前使用抗血小板药物对急性缺血性脑卒中患者静脉溶栓治疗效果的影响

摘要

目的 探讨发病前使用抗血小板药物对急性缺血性脑卒中患者静脉溶栓治疗效果的影响.方法 选取2015年6月—2017年6月自贡市第五人民医院收治的急性缺血性脑卒中患者126例,其中63例发病前未使用抗血小板药物者作为对照组,63例发病前使用抗血小板药物者作为研究组.抗血小板药物主要为阿司匹林,两组患者入院后根据发病时间采用重组组织型纤溶酶原激活剂(rt-PA)或尿激酶(UK)行静脉溶栓治疗.比较两组患者溶栓治疗后症状性颅内出血、颅内出血发生情况及溶栓治疗前后血压,采用改良版Rankin量表评价两组患者治疗1年后预后情况.结果 两组患者溶栓治疗后症状性颅内出血、颅内出血发生率比较,差异无统计学意义(P＞0.05).溶栓治疗前两组患者舒张压、收缩压比较,差异无统计学意义(P＞0.05);溶栓治疗后研究组患者舒张压、收缩压低于对照组(P＜0.05).两组患者中预后良好者所占比例比较,差异无统计学意义(P＞0.05).结论 发病前使用抗血小板药物可有效降低急性缺血性脑卒中患者静脉溶栓治疗后血压,不会增加颅内出血发生风险或对预后造成明显影响.%Objective To investigate the impact of premorbid use of anti-platelet drugs on venous thrombolytic therapeutic effect in patients with acute ischemic stroke. Methods A total of 126 patients with acute ischemic stroke were selected in the Fifth People's Hospital of Zigong from June 2015 to June 2017,thereinto 63 patients without premorbid use of anti-platelet drugs were served as control group,the other 63 patients with premorbid use of anti-platelet drugs were served as study group. Anti-platelet drugs mainly were aspirin,and patients in the two group received venous thrombolytic therapy of rt-PA or UK according to duration between attack and admission. Incidence of symptomatic intracranial hemorrhage and intracranial hemorrhage after venous thrombolytic therapy,blood pressure before and after venous thrombolytic therapy were compared between the two groups,and modified Rankin scale was used to evaluate the prognosis after 1 year of treatment. Results No statistically significant differences of incidence of symptomatic intracranial hemorrhage or intracranial hemorrhage was found between the two groups after venous thrombolytic therapy(P＞0.05). No statistically significant differences of DBP or SBP was found between the two groups before thrombolytic therapy(P＞0.05),while DBP and SBP in study group were statistically significantly lower than those in control group after thrombolytic therapy(P＜0.05). No statistically significant differences of proportion of patients with good prognosis was found between the two groups after venous thrombolytic therapy(P＞0.05). Conclusion Premorbid use of anti-platelet drugs can effectively reduce the blood pressure in acute ischemic stroke patients treated by venous thrombolytic therapy,with increasing the risk of intracranial hemorrhage or obvious influence on prognosis.