rhTNK-tPA静脉溶栓对急性脑梗死患者心功能及短期神经功能的影响

doi:10.3969/j.issn.1671-7171.2026.05.005

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摘要 【目的】探讨重组人TNK组织型纤溶酶原激活剂(rhTNK-tPA)静脉溶栓对急性脑梗死患者心功能及短期神经功能的影响。【方法】回顾性分析2022年1月至2023年10月本院收治的106例急性脑梗死患者的临床资料,根据治疗方法的不同将患者分为A组(给予rhTNK-tPA静脉溶栓治疗)和B组(给予阿替普酶静脉溶栓治疗),每组53例。对比两组心功能[每搏排血量(SV)、左室射血分数(LVEF)]、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分]、日常生活能力[Barthel指数(BI)评分]及并发症的发生情况。【结果】治疗后21 d,两组LVEF、SV均高于干预前,且A组高于B组,差异有统计学意义(P<0.05)。治疗后21 d,两组 NIHSS评分均低于治疗前,BI评分均高于治疗前,且A组NIHSS评分均低于B组,BI评分均高于B组,差异有统计学意义(P<0.05)。A组溶栓后脑出血发生率、治疗后6个月脑梗死复发率分别为13.21%(7/53)、5.66%(3/53),与B组的16.98%(9/53)、11.32%(6/53)比较,差异均无统计学意义(χ²=0.294、1.093,均P>0.05)。【结论】rhTNK-tPA静脉溶栓治疗急性缺血性脑卒中,可更有效地改善患者心功能、神经功能,提高日常生活能力,且安全性与阿替普酶相当,具有重要的临床应用价值。

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	李桂芬

关键词 ：脑梗死, 急性病, 血栓溶解疗法, 组织型纤溶酶原激活物, 心脏功能试验

Abstract：【Objective】 To explore the effects of intravenous thrombolysis with rhTNK-tPA on cardiac function and short-term neurological function in patients with acute cerebral infarction. 【Methods】 The clinical data of 106 patients with acute cerebral infarction admitted to our hospital from January 2022 to October 2023 were retrospectively analyzed. According to different treatment regimens, the patients were divided into Group A (treated with rhTNK-tPA intravenous thrombolysis) and Group B (treated with alteplase intravenous thrombolysis), with 53 cases in each group. The two groups were compared in cardiac function [Stroke Volume (SV), Left Ventricular Ejection Fraction (LVEF)], neurological function [National Institutes of Health Stroke Scale (NIHSS) score], activities of daily living [Barthel Index (BI) score] and the incidence of complications. 【Results】 At 21 days after treatment, LVEF and SV in both groups were higher than those before treatment, and Group A was higher than Group B (P<0.05). At 21 days after treatment, NIHSS scores of both groups were lower than before treatment, while BI scores were higher than before treatment; Group A had lower NIHSS scores and higher BI scores than Group B (P<0.05). The incidence of intracerebral hemorrhage after thrombolysis and the recurrence rate of cerebral infarction at 6 months after treatment in Group A were 13.21% (7/53) and 5.66% (3/53), respectively, versus 16.98% (9/53) and 11.32% (6/53) in Group B; there were no significant differences between the two groups (χ²=0.294, 1.093, all P>0.05). 【Conclusion】 Intravenous thrombolysis with rhTNK-tPA for acute ischemic stroke can more effectively improve patients' cardiac function and neurological function, and enhance activities of daily living. Its safety is equivalent to alteplase, which possesses important clinical application value.

Key words： Brain Infarction Acute Disease Thrombolytic Therapy Tissue Plasminogen Activator Heart Function Tests

收稿日期: 2025-04-10

中图分类号:

R743.33

引用本文:

李桂芬. rhTNK-tPA静脉溶栓对急性脑梗死患者心功能及短期神经功能的影响[J]. 医学临床研究, 2026, 43(5): 720-722.
LI Guifen. Effects of Intravenous Thrombolysis with rhTNK-tPA on Cardiac Function and Short-Term Neurological Function in Patients with Acute Cerebral Infarction. JOURNAL OF CLINICAL RESEARCH, 2026, 43(5): 720-722.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.05.005 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I5/720

[1] 吴俊乐. 急性脑梗死治疗研究新进展[J].首都食品与医药,2023,30(4):24-26.
[2] 梁菊萍,杨旸,董继存.急性脑梗死患者流行病学调查及危险因素[J].中国老年学杂志,2021,41(12):2484-2487.
[3] YU L, LI X T, HOU Y T, et al. Incidence and clinical features of acute multiple small cerebellar infarction[J].J Stroke Cerebrovasc Dis,2022,31(11):106777.
[4] 彭潇,蔡学礼,黄逸杰,等. 不同取栓方式治疗急性大脑中动脉M2段闭塞性脑梗死的疗效及安全性[J].温州医科大学学报,2023,53(10):795-800.
[5] 黄勇华,张微微,张国鲁,等.低剂量 rt-PA 联合尿激酶静脉溶栓治疗早期急性脑梗死的疗效及安全性评价[J].北京医学,2012,34(9):834-837.
[6] 翟玫,陈纪林,乔树宾,等. 注射用重组人TNK组织型纤溶酶原激活剂溶栓治疗急性ST段抬高型心肌梗死的疗效和安全性评价[J].中国新药杂志,2016,25(1):82-86.
[7] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-680.
[8] LYDEN P, RAMAN R, LIU L, et al. National Institutes of Health Stroke Scale certification is reliable across multiple venues[J].Stroke,2009, 40(7): 2507-2511.
[9] 闵瑜,吴媛媛,燕铁斌. 改良 Barthel 指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志,2008,30(3):185-188.
[10] 王拥军,李子孝,谷鸿秋.中国急性缺血性脑卒中溶栓治疗现状与展望[J].中华神经科杂志,2022,55 (1):17.
[11] 王陇德,刘建民,杨清武,等.中国脑卒中防治报告(2023)[J].中华脑血管病杂志(电子版),2023,17 (3):145158.
[12] 钟迪,张舒婷,吴波.《中国急性缺血性脑卒中诊治指南2018》解读[J].中国现代神经疾病杂志,2019,19(11):897-901.
[13] 张金凤,李光,苏果,等. 不明发病时间急性脑梗死患者的CTPI 溶栓抉择及疗效评价[J].内科,2018,13(4):547-550.
[14] 李波,童洋萍,云宗金.阿替普酶静脉溶栓治疗发病4.5 h内脑卒中患者出院后第90天临床结局的相关因素分析[J].河北医药,2024,30(11):1913-1917.
[15] 杨弋,刘鸣,崔丽英. 重组人TNK组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中中国专家共识[J].中华神经科杂志,2023,56(2):121129.
[16] 李刚,范其江,马云霞,等. 重组组织型纤溶酶原激活剂对急性缺血性脑卒中患者神经功能、预后的影响[J].国际医药卫生导报,2019,25(19):3242-3244.
[17] 董屹,鲍勇,胡承志,等. 重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死预后影响因素及血清胱抑素C水平对预后预测价值[J].临床军医杂志,2023,51(4):404-407.