早期静脉溶栓治疗急性轻型缺血性卒中的疗效观察  

Observation of curative effect of early intravenous thrombolysis treatment on acute minor ischemic stroke

作　　者：杨江胜[1,2] 朱祖福[1] 高志强[1] 张慧萍[1] 陆强彬[1] 方琪[3] 

机构地区：[1]东南大学医学院附属江阴市人民医院神经内科,214400 [2]苏州大学附属第一医院 [3]苏州大学附属第一医院神经内科

出　　处：《临床神经病学杂志》2017年第4期303-305,共3页Journal of Clinical Neurology

基　　金：无锡市卫生局面上项目(MS201409)

摘　　要：目的探讨早期静脉溶栓治疗急性轻型缺血性卒中的疗效及安全性。方法将70例首次急性轻型缺血性脑卒中患者随机分为溶栓组(35例)及未溶栓组(35例)。溶栓组于入院后给予重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗,未溶栓组给予阿司匹林(100 mg/d)口服。于出院时采用NIHSS评分评价患者神经功能缺损情况,治疗3个月后采用mRS评价患者预后。结果入院时溶栓组及未溶栓组患者一般临床资料差异无统计学意义(均P>0.05)。与未溶栓组患者比较,溶栓组患者出院时NIHSS评分显著降低,预后良好的比率显著增高(P<0.05~0.01)。两组患者均未发生症状性脑出血及死亡。结论静脉溶栓治疗可以显著改善轻型缺血性卒中患者的预后,并且不会增加其颅内出血的风险。Objective To evaluate the efficacy and safety early intravenous thrombolysis treatment on acute minor ischemic stroke. Methods Seventy patients with first-acute mild ischemic stroke were randomly divided into thrombolysis group（ 35 cases） and non-thrombolysis group（ 35 cases）. Thrombolysis group was received intravenous thrombolysis treatment with recombinant tissue plasminogen activator（ rt-PA） at admission,non-thrombolysis group was taken aspirin（ 100 mg/d） orally. Neurological deficit situation was evaluated by NIHSS at discharge,and the clinical outcome were evaluated by modified Rankin scale（ mRS） at 3 months after treatment. Results There was no significant difference of baseline clinical data at admission between thrombolysis group and non-thrombolysis group（ all P 0. 05）. Compared with non-thrombolysis group,NIHSS score in thrombolysis group at discharge was significantly decreased,and the rate of good prognosis in thrombolysis group at 3 month was significantly increased（ P 0. 05-0. 01）. There was no symptomatic intracerebral hemorrhage and died in the two groups. Conclusion Early intravenous thrombolysis treatment can improve the prognosis of acute minor ischemic stroke,and the risk of symptomatic intracerebral hemorrhage would not increase.

关 键 词：急性轻型缺血性脑卒中 静脉溶栓治疗 重组组织型纤溶酶原激活剂 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]