| Background and purpose:Cerebral infarction is limitations of brain tissue necrosis or softening which is induced by brain blood circulation disorder, ischemia and hypoxia. Currently infarction has become a health hazard for the elderly in our major diseases. Timely and effective treatment and the prognosis is closely related to. Currently accepted principles of acute cerebral infarction emphasis on early diagnosis, early treatment, early rehabilitation and early prevention of recurrence. Ultra-early thrombolytic therapy has been considered the most important measures to restore blood flow. Thrombolytic therapy of acute cerebral infarction began in the 20th century 80s, after more than 20 years of multi-drug number of large-scale multi-center,double-blind, placebo-controlled clinical trials have confirmed that thrombolytic therapy be used as early cerebral infarction Preferred method of treatment, evidence-based medicine guidelines recommend A-level choice for the treatment of ischemic stroke measures 3h intravenous recombinant tissue plasminogen activator for treatment. Despite a growing number of medical staff and patients recognize the importance of ultra-early thrombolytic therapy, but for various reasons, even in the United States has only 1.8 to 3.0% of ischemic stroke patients,64% of the hospitals in for thrombolytic therapy. And in China access to thrombolytic therapy is much less than 1% of patients. Some domestic research commonly used rt-PA thrombolytic therapy and current clinical drugs (Salvia, heparin, etc.) of the efficacy and safety were compared, these studies suggest that rt-PA thrombolytic therapy in acute cerebral infarction than in the past used drugs more safely and effectively. Sodium ozagrel with anti-platelet aggregation, inhibition of thrombosis and thrombus dissolution through functions, is currently the treatment of acute cerebral infarction commonly used drugs,its efficacy and safety was confirmed. But on the rt-PA intravenous thrombo-lytic therapy and intravenous therapy ozagrel acute cerebral infarction compared the efficacy and safety study is not yet reported. For further study of rt-PA thrombolytic therapy in acute cerebral infarction of the efficacy and safety, rt-PA thrombolytic therapy and intravenous drugs commonly used in domestic clinical intravenous treatment ozagrel compared. For the domestic standard treatment of acute ischemic stroke and to provide evidence,the experimental application of rt-PA thrombolytic therapy in acute cerebral infarction, and intravenous treatment of patients ozagrel a controlled study.Method:Analysis from January 2006 to October 2009 in our hospital neurology clinic with the standard thrombolytic therapy in 30 patients with onset of acute cerebral infarction within 3h, rt-PA group was 15 cases and either was control group. rt-PA group 3h time window for intravenous recombinant tissue plasminogen activator with the dose of 0.9mg/kg (maximum dose 90mg), the first intravenous injection of 10%(1min), the remaining dose continuous intravenous infusion,60min drops End.24h after thrombolysis, coagulation review series and head CT, after the exclusion of bleeding, given aspirin 300mg/d, orally, a total of 10 d, later changed to aspirin 100mg/d,orally.3h after onset of acute cerebral infarction in the control group given 80mg ozagrel sodium chloride injection, iv 2 times a day, of 14d. Improving brain cell metabolism and anti-brain edema the same two groups. Neurological deficit score and efficacy determination by the National Institutes of Health Stroke Scale (NIHSS) assessed before and after solution dissolved 24h,7d,14d,21d; Barthel ADL index (BI) assess the activities of daily living of 14d and 21d after dissolving. To 14d after thrombolysis within the secondary intracranial hemorrhage and death rates to assess safety.Result:rt-PA group and the control group the sex ratio, age, past history, with the incidence and initial neurological function scores were not statistically different (P>0.05); After treatment,7d,14d,21d showed that 7d after treatment was no significant difference,14d,21d after treatment the rt-PA group to better effect than the control group, significant difference (P<0.05); 14d recovery rate of the two groups of daily living (BI>95 points) was no significant difference,21 d ADL recovery rate of 26.6% of rt-PA group, control group 1 cases (P<0.05); rt-PA group and the control group there was no one case of symptomatic intracranial hemorrhage; rt-PA group and the control group mortality was 13.3%,6.6%(P>0.05); rt-PA group and the control group of vascular re-occlusion rate was 6.66%,13.3%(P>0.05).Conclusion:1.This study shows that rt-PA group and the control group at each time point after treatment, NIHSS score, BI index before treatment were significantly improved, but with the treatment time, rt-PA group than in the control group improved more significantly. It showed that rt-PA intravenous thrombolytic therapy can significantly improve prognosis and reduce disability, improve quality of life.2.rt-PA group and the control group had no symptoms of cerebral hemorrhage, the two groups no significant differences in mortality, suggesting the two drugs are the treatment of acute cerebral infarction is safe.3.Meet the indications for thrombolytic therapy of acute cerebral infarction recommend early application of rt-PA thrombolytic therapy in order to achieve the best effect. |
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