不同溶栓方案治疗不同特征超早期急性脑梗死的效果分析

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中图分类号：R743.3 文献标志码：A DOI：10.11958/20250926

Curative efect diferent thrombolytic regimens on patients with ultra-early acute cerebral infarction differentcharacteristics

ZHANG Hanwen1，LI Qiang1△， YANG Xuelian1， YANG Hualan²， JIANG Mei1，HUANG Shu1 1， ， 2ol35，2 ， △Corresponding Author E-mail： lqsmmu@126.com

Abstract：ObjectiveTo explore curative efect two thrombolyticregimens in the treatment ultra-early acute cerebral infarction（ACI）diferentagegroupsanddiferentthrombolytictimewindows.MethodsAtotal166patients withACIwereenroled，withintervalfromonset totreatment≤4.5h.Accordingtodiferentthombolyticregiments，patients were divided into therecombinant tissue plasminogenactivator（rt-PA）group （104 cases，intravenous thrombolysis with 0.9 mg/kg rt-PA）and the tenecteplase （TNK） group （62 cases，intravenous thrombolysis with 0.25mg/kg TNK）. According to dierent age groups and different thrombolytic time windows，patients were divided into the high age group （ ⩾ 70 years）， the low age group （ <70 years），the short time window group （ Θ<Θ3 h） and the long time window group （3-4.5 h）. After thrombolysis，laboratoryindexes[neutrophil（NEU），lymphocyte（LYM）]，soresNationalInstitutesHealthrokeSale （NIHSS），modifiedRankinscale（mRS）and incidence adverseeventswerecompared indifferentgroups by factorial analysis method.ResultsThere was no significant diference inany index between thert-PA groupand the TNK group 0 P>0.05 ）.Compared with thehighage groupat7dafterthrombolysis，NIHSSscore，NEU，neutrophil tolymphocyteratio （NLR）and high sensitive C-reactive protein （hs-CRP）were lower，while LYMand albumin（ALB）were higherin the lowage group （ P<0.05 ）. Compared with the long time window group，NEUand NLR were lower，while LYM was higher in the short time window group （P<0.05） ）.There wasno significant difference in total incidence adverse events within 14d thrombolysis between the different age groups and the different thrombolytic time window groups （ P>0.05 ）.Conclusion

For patients with ultra-early ACI，O.9 mg/kg rt-PA and 0.25mg/kg TNK have comparable efficacy in intravenous thrombolysis，and both have better effects when patient age is <70 years old and the thrombolysis time window is <3 hours. Keywords：cerebral infarction;acutedisease;fibrinolyticagents；age factors;time factors;rootcauseanalysis; recombinant tissue plasminogen activator; tenecteplase

急性脑梗死（acutecerebralinfarction，ACI）又称缺血性脑卒中，是中老年人群中常见的脑血管系统疾病，可导致患者偏瘫、失语、意识障碍等。（剩余12613字）