急性脑梗死超早期重组组织型纤溶酶原激活物溶栓治疗的临床研究

目的:探讨发病6h内急性脑梗死给予重组组织型纤溶酶原激活物(rt-PA)溶栓治疗的疗效及并发症,并分析预后相关因素。方法:共收集本院2001-2005年70例溶栓治疗的急性脑梗死病例,其中52例静脉溶栓,18例动脉溶栓,分析比较两组病例溶栓前后及3个月随访的ESS评分及Barthel指数结果;同时分析与预后相关的因素。结果:静脉和动脉溶栓组溶栓前及溶栓30min后ESS评分及Barthel指数迅速增加,溶栓前后分值有显著差异。1个月内颅内出血率为5.77%(静脉组)和16.67%(动脉组)。3个月时ESS评分及Barthel指数较溶栓后30min的评分有显著改善。结论:6h内动脉、静脉溶栓治疗均安全有效。

The Clinical Study of Thrombolysis with rt-PA in Acute Ischemic Stroke

Aim: To investigate the curative effect and complications of thrombolysis with recombinant tissue plasminogen activator (rt-PA) in acute ischemic stroke within 6 hours of symptom onset,and analyse the factors related the outcomes. Methods: 70 cases of acute cerebral infarction within 6 hours who were treated with rt-PA 52 cases with intra-venous (IV) and 18 cases with intra-arterial (IA) ] were evaluated retrospectively during 2001- 2005. We evaluate the European Stroke Scale (ESS) and the Barthel Index(BI) which were measured in two groups respectively before and after thrombolysis and following up for 3 months. Also we analyse the complications of the prognosis. Results: In the IV and IA group, the ESS scores and Barthel Index increased rapidly after thrombolysis with significant difference. The hemorrhage rates were 5.77% (IV) and 16.67% (IA). Patients who are young or with low NIHSS or high ESS score or high BI score evaluated after thrombolysis have good prognosis. Conclusion: Thrombolysis with rt-PA in acute ischemic stroke within 6 hours from the onset is relatively safe and effective.