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

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

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。

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） groups respectively before and after thrombolysis and fo and the Barthel Index （ BI ） which were measured in two 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.