| 李凤,应佳桓,江艳柳,等.替奈普酶与阿替普酶在急性脑梗死患者静脉溶栓治疗中的效果对比及人工智能的预测价值[J].中国临床保健杂志,2025,28(3):358-361. |
| 替奈普酶与阿替普酶在急性脑梗死患者静脉溶栓治疗中的效果对比及人工智能的预测价值 |
| Comparative study on the therapeutic efficacy of tenecteplase versus alteplase in intravenous thrombolysis for acute cerebral infarction and artificial intelligence prediction |
| 投稿时间：2025-05-10 |
| DOI：10.3969/J.issn.1672-6790.2025.03.015 |
| 中文关键词: 脑梗死 替奈普酶 阿替普酶 纤维蛋白溶解药 人工智能 |
| 英文关键词: Brain infarction Tenecteplase Alteplase Fibrinolytic agents Artificial intelligence 〖FL |
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| 中文摘要: |
| 目的 比较急性脑梗死患者使用替奈普酶与阿替普酶静脉溶栓的治疗效果和安全性,并观察人工智能技术对于药物疗效的预测价值。方法 采用病例对照分析2023年1月至2025年4月安徽省第二人民医院神经内科收治的102例静脉溶栓患者临床资料,其中50例使用替奈普酶,52例使用阿替普酶。比较2组患者静脉溶栓治疗后24 h以及第7天美国国立卫生研究院卒中量表(NIHSS)评分的改善程度,30 d卒中复发率,36 h脑出血情况,以及36 h其他严重不良反应的发生率。在此基础上,依据102例患者的临床数据构建医学人工神经网络模型,预测患者选择替奈普酶或阿替普酶的治疗效果和安全性。结果 替奈普酶组治疗24 h时NIHSS评分改善≥4分的比例为52.00%,阿替普酶组治疗24 h时NIHSS评分改善≥4分的比例为69.23%,2组差异无统计学意义(P>0.05)；替奈普酶组治疗7 d时NIHSS评分改善≥4分的比例为72.00%,阿替普酶组治疗7 d时NIHSS评分改善≥4分的比例为84.62%,2组差异无统计学意义(P>0.05)。治疗后30 d内,2组患者均无复发。2组患者的36 h脑出血以及36 h其他严重不良反应比较,差异无统计学意义(P>0.05)。该研究构建的医学人工神经网络模型提示,构建的模型预测患者选择静脉溶栓药物的治疗效果和安全性结局的准确率＞71.6%。结论 对于符合静脉溶栓治疗标准的急性脑梗死患者,应用替奈普酶与阿替普酶在溶栓效果和安全性方面相当。医学人工神经网络模型对于是否选择静脉溶栓、选择替奈普酶或阿替普酶的治疗效果和安全性的预测可提供一定的参考依据。 |
| 英文摘要: |
| Objective To compare the differences in therapeutic efficacy and safety between tenecteplase and alteplase for intravenous thrombolysis in patients with acute cerebral infarction and to evaluate the predictive performance of artificial intelligence technology for drug efficacy outcomes.Methods This case-control study included 102 patients (50 receiving tenecteplase,52 receiving alteplase) who underwent intravenous thrombolysis in the Department of Neurology at Anhui No.2 Provincial People′s Hospital from January 2023 to April 2025.The following outcomes were compared between groups:improvement in National Institute of Health stroke scale (NIHSS) scores (≥4 points) at 24 hours and 7 days post-thrombolysis,30-day stroke recurrence rate,36-hour intracranial hemorrhage incidence,and 36-hour incidence of other severe adverse events.A medical artificial neural network (ANN) model was constructed using clinical data from these 102 patients to predict therapeutic efficacy and safety outcomes associated with tenecteplase versus alteplase.Results Therapeutic efficacy:at 24 hours,52.00% of the tenecteplase group and 69.23% of the alteplase group achieved NIHSS improvement ≥4 points (P>0.05,nonsignificant);at 7 days,72.00% of the tenecteplase group and 84.62% of the alteplase group achieved NIHSS improvement ≥4 points (P>0.05,nonsignificant);no 30-day acute cerebral infarction recurrences were observed in either group.Safety:in terms of incidence of intracerebral hemorrhage within 36 hours,and other severe adverse effects within 36 hours,no statistically significant differences are observed between the two groups (P>0.05).The medical ANN model demonstrated an accuracy rate> 71.6% in predicting therapeutic efficacy and safety outcomes for thrombolytic agent selection.Conclusions For acute cerebral infarction patients eligible for intravenous thrombolysis,tenecteplase is non-inferior to alteplase in terms of efficacy and safety.The medical ANN model provides preliminary theoretical support for predicting outcomes related to thrombolytic agent selection (tenecteplase vs alteplase),potentially aiding clinical decision-making for intravenous thrombolysis. |
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