急性轻型缺血性卒中6～9小时动脉尿激酶溶栓治疗回顾性分析

Retrospective Analysis of Curative Effects of Selective Intra-arterial Urokinase Thrombolysis for Patients with Mild Acute Ischemic Stroke within 6～9 Hours

目的探讨发病6-9 h动脉溶栓治疗对美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）〈5分的急性缺血性卒中患者的治疗效果。方法回顾86例发病距接受治疗的时间6-9 h的急性缺血性卒中（NIHSS〈5分）患者资料,比较选择性尿激酶动脉溶栓和口服阿司匹林2种治疗方法的发病7 d和90 d效果。结果与口服阿司匹林组相比,选择性动脉溶栓组患者发病7 d的Barthel指数（Barthel index,BI）较对照组明显改善（81.3±7.9 vs 54.5±9.3,P=0.034）,改良Rankin量表（modified Rankin Scale,m RS）评分〈3分的患者比例明显增加（88.4%vs 48.8%,P=0.028）;但在90 d后,两组患者的BI及m RS之间没有显著差异。结论对急性轻型缺血性卒中6-9 h积极的动脉尿激酶溶栓治疗可以促进患者的早期恢复。

Objective To evaluate the curative effects and security of intra-arterial thrombolysis for mild acute ischemic stroke（NIHSS5） in 6-9 hours time window.Methods Restrospective analysis was made based on the data of 86 mild acute ischemic stroke patients（NIHSS5） who received treatment within 6-9 hours after onset. The therapeutic effects of intra-arterial thrombolysis by using urokinase and aspirin on 7th day and 90 th day after onset were compared. Results Compared with prescribed aspirin, the BI（81.3±7.9 vs 54.5±9.3, P =0.034） of thrombolysis group increased signifi cantly on the 7th day of hospitalization, while the m RS（88.4% vs 48.8%, P =0.028） decreased obviously. Neither m RS nor BI had signifi cant difference between two groups after 90 days.Conclusion Intra-arterial thrombolysis is a safe and effective therapeutic method for mild acute ischemic stroke within 6-9 hours, which benefi ts early recovery.