功能磁共振成像对尿激酶静脉溶栓治疗超急性期脑梗死的临床价值

目的:探讨功能磁共振(MRI)成像对尿激酶静脉溶栓治疗超急性期脑梗死的指导作用.方法:我院2004年7月至2010年7月尿激酶静脉溶栓治疗患者62例,其中溶栓前功能头颅MRI检查(32例,MRI组)、CT检查(30例,CT组),以同期非溶栓治疗的超急性期脑梗死30例为对照组,于24 h内、7天、30天复查头颅CT或MRI.结果:各时点溶栓组完全恢复及基本恢复率明显高于对照组(P＜0.01),溶栓组脑出血发生率与对照组无显著差异(P＞0.05),但MRI组的出血率明显低于CT组(P＜0.05).结论:尿激酶静脉溶栓治疗超急性脑梗死安全、有效,弥散加权成像(DWI)和灌注加权成像(PWI)MRI检查使尿激酶静脉溶栓治疗的选择更趋合理.

Clinical Valume of Functional Nuclear Magnetic Resonance in Patients with Hyper-acute Cerebral Infarction with Intravenous Thrombolysis of Urokinase

Objective： To explore the guidance of nuclear magnetic resonance （MR/） in patients with hyperacute cerebral infractions with intravenous thrombosis of urokinase. Method：62 were suitable to received intravenous thrombosis of urokinase were analyzed from Jul 2004 to Oct 2007. 32 were examed by head MRI（MRI group）and 30 by CT （CT group） before the thrombolysis,30 at the same stage who didn＇t receive thrombolysis were in the control group. Head CT or MRI were rechecked at days 1,7,30 after the thrombolysis. Result： The complete or basical recovery rates of thrombolysis group were significantly higher than that in the control group （P〈0.01）. Brain hemorrhage incidence of thrombolysis group was no significantly difference than that in the control group （P〉0.05）, but the brain hemorrhage rate was lower in the MRI group than that in the CT group （P〈0.05）.Conclusion： Intravenous thrombolysis of urokinase in patients with hyper-acute cerebral infractions is safe and effective. DWI and PWI MRI make the choice of intravenous thrombolysis of urokinase more reasonable.