急性脑梗死动脉溶栓血管再通对急性期预后的影响

目的研究经动脉溶栓治疗急性脑梗死患者,梗死相关血管再通对近期预后的影响。方法回顾性分析2007年9月～2010年9月在本院神经内科收治的急性脑梗死动脉溶栓患者58例。采用Gon-ner的血管再通分级标准判断血管再通,利用美国国立卫生研究院卒中量表评分(NIHSS),比较再通与未通组神经功能缺损情况。用MRS评价神经功能恢复状况。结果 58例中再通38例(65.5%),未通20例(34.5%)。溶栓治疗后血管再通组1 h NIHSS(19.00±3.54)较血管未通组(26.50±3.10)明显降低(p<0.05);溶栓治疗后30 d血管再通组NIHSS(12.25±3.15)明显低于血管未通组(19.12±3.35),p<0.05]。治疗1～30 d,血管再通组NIHSS评分低于对照组(p<0.05)。血管再通组30 d预后良好为28例(73%),而血管未通组预后好良好为7例(35%)(p<0.05)。结论急性脑梗死动脉溶栓后血管再通对改善急性期预后起十分重要作用。

THE EFFECT OF VESSEL REPERFUSION BY ARTERIAL THROMBRLYSIS OF ACUTE CEREBRAL INFARCTION ON PROGNOSIS OF ACUTE STAGE

Objective To observe the recent effect of aterial thrombolysis on acute cerebral infarction in the recent prognosis improvement via reperfusion of thrombosis related vessels.Methods 58 patents of vessel reperfusion by arterial thrombolysis were retrospectively analyzed from department of Neurology,Zhan Jian Central People＇s Hospital,Zhanjian province during September 2007 to September 2010.The vessel reperfusion was judged by Gonner criterion,and the situation of neurologic impairment between groups of vessel reperfusion was judged by NIHSS.The prognosis of neurologic function was evaluated by MRS.Results There were 38 cases of reperfusion（65.5%） and 20 cases of nonperfusion（34.5%） among 58 patients.The NIHSS scores in reperfusion group（19.00±3.54）was obviously lower than nonperfusion group（26.50±3.10）（0.05） after 1h therapy of thrombolysis.the NIHSS scores in reperfusion group（12.25±3.15） was lower then nonperfusion group （19.12±3.35）,p0.05] after 30 d therapy of thrombolysis.During therapy 1~30 d,the NIHSS scores in reperfusion group was lower than control group（p0.05）.The good prognosis cases was 28（73%） in reperfusion group after 30 days,and 7 cases（35%） in nonperfusion group（p0.05）.Conclusion Vessel reperfusion by arterial thrombolysis has very important effect on prognosis of acute stage in acute cerebral infarction patients.