关键词: 组织型纤溶酶原激活物; 剂量效应关系; 药物; 治疗结果; 颅内出血; 死亡率

Abstract: Objective FDA recomanded 0.9mg/kg IV rt-PA in thrombolysis treatment for acute ischemic stroke.The trials about IV rt-PA in china have chosen some different dose. To analyze the suitable dosage of rt-PA in Chinese we compared 0.9mg/kg IV rt-PA with 0.6-0.8mg/kg(50mg/person) IV rt-PA.Methods 30 patients were randomly assigned in our study. The NIHSS were from 2 to 26, the stroke onset time is 0.5 to 6 hours, without contraindications to thrombolytic therapy(China cerebrovasculardisease guide contraindication of thrombolysis). The patients were randomly divided into Group A and B, Group A with rt-PA 50mg/person, Group B with rt-PA 0.9mg/kg. To compare between two groups the number of patients with a decrease of 4 or more points on the National Institutes of HealthStroke Scale (NIHSS) at 24 hours and day 14. The intracerebral hemorrhage rate and mortality were also be compared.Results The two groups were well matched on baseline characteristics, including NIHSS (mean of 10.17for both). NIHSS improvement rate of group B at day 14 is signifcient better than group A (86.67% vs 53.3%, P <0.05).The intracerebral hemorrhage rate of two groups were both 6%. Themortality at 14 days in Group A were higher than Group B(26.67% vs 20%, P =0.67).Conclusion This study found significant benefit on 14 days in patients treated by 0.9mg/kg IV rt-PA than (0.6-0.8)mg/kg(50mg/person) IV rt-PA after stroke onset. Risk of intracerebral hemorrhage and mortality was not increased in 0.9mg/kg IV rt-PA. 0.9mg/kg IV rt-PA was suitable for Chinese inthrombolysis treatment for acute ischemic stroke.

Key words: Tissue plasminogen activator; Dose-response relationship; drug; Treatment outcome; Intracerebral hemorrhages; Mortality