重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中前后循环梗死疗效比较

Comparison the therapeutic effective between anterior circulation and posterior circulation with recombinant tissue plasminogen activator thrombolysis on acute ischemic stroke

目的比较使用重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性缺血性卒中患者前后循环梗死的临床疗效。方法回顾性分析3l例发病在6h内的急性缺血性脑卒中患者的临床表现、治疗方法及疗效。其中前循环梗死22例,后循环梗死9例,在溶栓前和溶栓后2h、24h、7d时,定期对患者进行神经功能缺损测评(NIHSS评分),并进行比较。结果静脉溶栓治疗前前循环与后循环组间患者血压、NIHSS评分、发病时间、住院天数等基础情况比较差异无统计学意义(P>0.05)。静脉溶栓治疗后各时间点2组均较溶栓前显著下降(P<0.05),且后循环NIHSS评分下降较前循环明显(P<0.05)。结论 rt-PA静脉溶栓治疗急性缺血性卒中后循环梗死临床疗效较前循环更明显。

Objective To explore the clinical effects of infarction in the use of recombinant tissue plasminogen activator （rt-PA） thrombolytic therapy for acute ischemic stroke between anterior circulation and posterior circulation.Methods Retrospective analysis of 31 patients within 6h of onset in acute ischemic stroke patients with clinical manifestations,treatment and efficacy,of which 22 cases of anterior circulation infarction,9 cases of posterior circulation infarction.The neurological deficits（NIHSS score） were evaluated and compared before and after thrombolysis thrombolytic 2h,24h,7d.Results Before intravenous thrombolytic therapy,there were no statistical difference between two groups,included age,blood pressure,treatment time（P0.05）.After intravenous thrombolytic therapy,posterior circulation infarction group compared with the anterior circulation infarction group,the NIHSS score decreased significantly（P0.05）.Conclusion It demonstrated that the treatment of rt-PA intravenous thrombolytic therapy for acute ischemic stroke had better clinical efficacy in posterior circulation infarction than that in the anterior circulation infarction.