急性大脑中动脉闭塞性脑梗死静脉溶栓后血管再通与预后  

The Recanalization and Prognosis of Acute Cerebral Infarction Patients with Middle Cerebral Artery Occlusion after Intravenous Thrombolytic Treatment

作　　者：廖晓凌[1] 王伊龙[1] 潘岳松[1] 王春娟[1] 陈胜云[1] 赵性泉[1] 王春雪[1] 刘丽萍[1] 王拥军[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心,北京100050

出　　处：《中国卒中杂志》2016年第10期824-828,共5页Chinese Journal of Stroke

基　　金："十二五"及"十一五"国家科技支撑计划(2011BAI08B02;2006BA101A11)

摘　　要：目的探讨急性大脑中动脉闭塞性脑梗死后静脉溶栓的血管再通情况及其与预后关系。方法回顾性选取大脑中动脉闭塞性脑梗死静脉溶栓患者资料,分析溶栓后血管再通情况,并对再通组与无再通组的有效性及安全性结局进行比较分析。结果共入选67例患者,溶栓后血管再通率为55.2%,有再通组(37例)90 d随访获得生活自理(72.97%vs 43.33%,OR=3.5,P=0.014)及良好预后(64.86%vs 26.67%,OR=5.1,P=0.002)的比例均显著优于无再通组(30例),而两组的症状性颅内出血发生率及死亡率均无显著性差异。结论大脑中动脉闭塞性脑梗死患者静脉溶栓也具有较高的血管再通率,血管再通与预后显著相关,桥接治疗是最佳选择。Objective To investigate the association between recanalization and prognosis of acute cerebral infarction patients with middle cerebral artery（MCA） occlusion after intravenous thrombolytic treatment.Methods The data of acute cerebral infarction patients with MCA occlusion who received intravenous thrombolytic treatment were retrospectively analyzed. The recanalization rate after thrombolysis was analyzed. The safety and efficacy outcome between recanalization group and no recanalization group were compared.Results A total of 67 patients were included. The rate of recanalization of MCA was 55.2%. For the functional independence outcome at 90 days, recanalization group（n =37） was significantly better than no recanalization group（n =30）（72.97% vs 43.33%, OR =3.5, P =0.014）. For the excellent recovery outcome at 90 days, the former was also significantly better than the latter（64.86% vs 26.67%, OR=5.1, P=0.002）. There were no significant differences for the symptomatic intracranial hemorrhage and mortality between the two groups.Conclusion The recanalization rate of acute cerebral infarction patients with MCA occlusion is relatively high, and recanalization is strongly associated with prognosis. For these patients, bridgetreatment is the optimal choice.

关 键 词：脑梗死 溶栓 再通 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]