多模式MRI对急性缺血性脑卒中静脉溶栓治疗指导的临床价值

Clinical Value of Multi-mode MRI in the Guidance of Venous Thrombolytic Therapy for Acute Cerebral Ischemic Stroke

目的探讨多模式MRI对急性缺血性脑卒中(ACIS)静脉溶栓治疗指导的临床价值。方法回顾性分析2017年01月~2018年01月我院收治的70例ACIS患者的临床资料,根据治疗方法的不同分为对照组(n=35)和观察组(n=35),对照组给予常规抗血栓治疗,观察组给予多模式MRI指导下静脉溶栓治疗,比较两组临床疗效、神经功能缺损(NIHSS)评分、日常生活能力(Barthel指数)评分、血清CRP水平及安全性。结果治疗后观察组总有效率91.43%、血管再通率94.29%,显著高于对照组的71.43%和74.28%(P<0.05);治疗后观察组NIHSS评分和血清CRP水平均低于对照组,Barthel指数评分高于对照组(P<0.05);两组总不良反应发生率无显著差异(P>0.05)。结论多在模式MRI指导下静脉溶栓治疗ACIS的疗效显著,可有效改善神经功能,提高日常生活能力,且安全性较高。

Objective To investigate the clinical value of multi-mode MRI in the guidance of venous thrombolytic therapy for acute cerebral ischemic stroke. Methods The clinical data of 70 patients with ACIS admitted to the hospital from January 2017 to January 2018 were retrospectively analyzed. According to the different treatment methods, they were divided into control group(n=35) and observation group(n=35). The control group was given routine antithrombotic therapy. The observation group was given venous thrombolytic therapy under the guidance of multi-mode MRI. The clinical curative effect, score of National Institutes of Health Stroke Scale(NIHSS), score of daily living ability(Barthel index), serum CRP level and safety were compared between the two groups. Results After treatment, the total response rate and the vascular recanalization rate in the observation group were 91.43% and 94.29%, which were significantly higher than those in the control group(71.43%, 74.28%)(P<0.05). After treatment, the NIHSS score and serum CRP level in the observation group were lower than those in the control group,while the score of Barthel index was higher than that in the control group(P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion The curative effect of venous thrombolytic therapy is significant on ACIS under the guidance of multi-mode MRI. It can effectively improve neurological function, improve daily living ability, with relatively higher safety.