rt-PA静脉溶栓治疗轻型急性缺血性卒中临床疗效评价

Clinical Evaluation of Intravenous rt-PA Thrombolysis in the Treatment of Acute Minor Ischemic Stroke

目的:研究重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗轻型急性缺血性卒中的疗效及安全性.方法:选取发病时间4.5h内的急性缺血性卒中34例,美国国立卫生研究院卒中量表(NIHSS)评分≤5,溶栓组16例给予rt-PA静脉溶栓,对照组18例,入院即给予拜阿司匹林口服等常规治疗.依据治疗后7d、90d的NIHSS评分、7d疗效、90d改良Rankin(m RS)评分、治疗期脑出血转化率及90d死亡率,评价治疗的有效性和安全性.结果:两组治疗7d时NIHSS评分及疗效无统计学意义(P>0.05),90d时NIHSS评分,溶栓组明显低于对照组(P<0.05),90d预后良好率溶栓组高于对照组(P<0.05).两组未发生颅内出血及死亡事件.结论:rt-PA静脉溶栓治疗轻型缺血性卒中有效且安全.

Objective： To study the efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator（rt-PA） in the treatment of acute mild ischemic stroke. Methods： 34 cases of acute ischemic stroke within 4.5 hours of onset,and the National Institutes of Health Stroke Scale（NIHSS） score ≤5 were selected. The thrombolysis group（n= 16） received intravenous rt-PA thrombolysis,the control group（n= 18） received oral aspirin and other conventional treatment immediately after hospitalization. According the NIHSS score of 7 d and 90 d after treatment,the curative effect of 7 d,the modified Rankin（m RS） score of 90 d,the incidence of intracranial haemorrhage during treatment and the mortality at 90 d,to evaluate the effectiveness and safety of the treatment. Results：The NIHSS score and curative effect of two groups were not statistically significant（P 0.05） after treatment 7 days.But the NIHSS scores of 90 d in the thrombolytic group were significantly lower than those of control group（P0.05）,and the good prognosis rates of 90 d was higher than the control group（P0.05）. No intracranial hemorrhage and death occurred in two groups. Conclusion： Intravenous rt-PA thrombolytic therapy is an effective and safe method in the treatment of acute mild ischemic stroke.