对rt-PA治疗脑梗塞中颈动脉粥样硬化影响的再讨论

Discussing Again the Effect of Carotid Athroma on the Cerebral Infarction Treated by rt-PA

目的；人体组织纤维蛋白溶解酶原酶（ｔ－ＰＡ）治疗不同病因脑梗塞的疗效的再探讨。方法：以颈动脉和心脏Ｄｏｐｐｌｅｒ超声和数字式血管造影（ＤＳＡ）的检查结果为依据作分组对比分析ｒｔ－ＰＡ的治疗效果。结果：ｒＴ－ＰＡ治疗后２４ｈ症状改善与预后有关。颈动脉粥样硬化性完全梗塞和严重狭窄组病例溶栓起效时间明显推迟（Ｐ＜０．０５）。３个月后颈动脉完全梗塞组６８．７５％有严重神经系统后遗症。结论：颈动脉粥样硬化性梗塞和严重狭窄是影响溶栓治疗预后的一个重要因素。

Aim: To discuss the result of therapy with rt-PA in cerebral infarction with different etiology. Methods: The grouping in etiology was constituted with the results of carotid and cardiac echo-Doppler and digital subtract angiography (DSA) to compare and analyse the effect of rt-PA. Results: It is correlated between the prognosis and the recuperation in 24h after rt-PA. The duration from therapy of thrombolysis to clinical syndrome ameliorated was more prolonged in groups of atheroma thrombosis and severe stenosis (P<0.05). 68.75% of cases with a severe handicap in the group of atheroma thrombosis after 3 months. Conclusion:Carotid atheroma thrombosis and severe stenosis are an important factor to interrupt the result of thrombolyse.