急性脑梗死动脉溶栓治疗效果与残存正向血流的相关性

The correlation of thrombolytic therapy results in acute cerebral infarction and the remaining positive blood flow

目的 分析影响急性脑梗死动脉溶栓治疗效果的相关因素,评价其与残存正向血流的相关性。方法 将2011年4月~2014年4月于我院接受治疗的83例急性脑梗死患者作为研究对象,回顾性分析其临床资料,并严格参照患者残存正向血流将其分为A、B两组,A组为正向血流及侧支循环组,共43例,B组则为无正向血流及侧支循环组,共40例,两组患者均给予动脉溶栓治疗,比较治疗2周后,两组患者出血性转化状况及神经功能缺损评分改善情况。结果 溶栓治疗2周后,A组患者神经缺损功能降低至（6.0±3.3）分,明显低于B组的（8.7±5.1）分;且A组患者接受治疗后,40例溶栓血管完全再通或部分再通,再通率为93.0%,无一例患者有症状性出血表现,B组则35例血管再通,再通率为87.5%,且3例患者有症状性出血表现,其出血率明显高于A组（P〈0.05）;A组痊愈6例,显效23例,好转9例,总有效率为83.7%,明显高于B组的42.5%,组间比较差异明显（P〈0.05）。结论 残存正向血流是维持患者脑组织正常血运状况的重要因素,同样也是影响急性脑梗死动脉溶栓治疗效果的关键,可据患者的残存正向血流量,适当延长动脉溶栓治疗时间,以保证治疗效果,降低脑组织损伤。

Objective To analyze the factors influencing the curative effect of arterial thrombolytie treatment in acute cerebral infarction, and evaluate the correlation between remaining positive blood flow and it. Methods 83 patients with acute cerebral infarction who were treated in our hospital from April 2011 to April 2014 were selected as research objects and the clinical data was retrospectively analyzed. They were allocated to two groups closely according to the remaining positive blood flow of patients. There were 43 patients in group A with a positive blood and collateral circulation. There were 40 patients in group B with a non-positive blood and collateral circulation. Patients in two groups were all treated with arterial thrombolytic treatment. Hemorrhagic transformation status and improvement of neurological deficit scores of 2 weeks after treatment of patients were compared. Results 2 weeks after arterial thrombolysis, neurological deficit scores of patients in group A was decreased to （6.0 ＋ 3.3） points, significantly lower than that in group B （8.7 ＋ 5.1） points. After treatment, there were 40 patients of thrombolysis completed recanalization or partial recanalization in group A, and the recanalization rate was 93.0%, with no patient with symptomatic hemorrhage. After treatment, there were 35 patients of recanalization in group A, and the recanalization rate was 87.5%, with 3 patients with symptomatic hemorrhage. The bleeding rate of group B was significantly higher than that of group A （P 〈 0.05）. In group A, there were 6 cases of cure, 23 cases of marked effect and 9 cases of good histamine. The total effective rate of group A was 83.7%, significantly higher than that of group B 42.5%. There were significant differences with between two groups when comparing （P 〈 0.05）. Conclusion Remaining positive blood flow is an important factor in maintaining normal blood supply in patients with brain conditions and also the key to affecting arterial thrombolytic treatment of acute cerebral infarction. Time of arterial thrombolytic treatment can be appropriately extended to ensure the curative effect and reduce brain damage according to remaining positive blood flow volume.