rt-PA静脉溶栓对脉络膜前动脉梗死病情进展及预后的影响  

Effect of rt-PA intravenous thrombolysis on the progression and prognosis of cerebral infarction in the anterior choroidal artery

作　　者：张翠翠 刘海艳 魏秀娥 付家亮 刘腾飞 许静 ZHANG Cuicui;LIU Haiyang;WEI Xiu’e;FU Jialiang;LIU Tengfei;XU Jing(Department of Neurology,Second Affiliated Hospital of Xuzhou Medical University/General Hospital of Xuzhou Mining Group,Xuzhou 221000,China)

机构地区：[1]徐州医科大学第二附属医院(徐州矿务集团总医院)神经内科

出　　处：《中国实用神经疾病杂志》2019年第7期732-736,共5页Chinese Journal of Practical Nervous Diseases

基　　金：徐州市重点研发计划(社会发展)项目(编号:KC7176)

摘　　要：目的 探讨rt-PA静脉溶栓对脉络膜前动脉供血区脑梗死病情进展及预后的影响。方法 采用前瞻性研究方法,入组发病4.5h内脉络膜前动脉区脑梗死患者68例,根据治疗方法分为rt-PA溶栓组40例和非溶栓组28例,比较2组进展性卒中的发生率、治疗后14dNIHSS评分改善情况,以及治疗前、治疗后90d、1aMRS评分。结果 rt-PA溶栓组与非溶栓组进展性卒中的发生率无明显变化;治疗后14d溶栓组NIHSS评分改善4分以上比例高于非溶栓组,治疗后90d、1aMRS评分0~2分比例均高于非溶栓组,差异有统计学意义(P<0.05)。结论 脉络膜前动脉区脑梗死发病4.5h内进行rtPA静脉溶栓治疗未能降低进展性卒中发生率,但其与非溶栓组相比,其近、远期预后均较好。Objective To investigate the effect of rt -PA intravenous thrombolysis on the progression and prognosis of cerebral infarction in the anterior choroidal artery. Methods A prospective study was performed in 68 patients with cerebral infarction in anterior choroidal artery within 4.5 hours of onset.40 patients were enrolled in the rt PA thrombolysis group,and 28 patients were in non thrombolytic group.The incidence of progressive stroke,the improvement of NIHSS score 14 days after treatment and the MRS scores before treatment,90 days after treatment and 1 year after treatment in the two groups were compared. Results There was no significant change in the incidence of progressive stroke compared between the rt- PA thrombolysis group and the non thrombolytic group.The ratio of cases with an increase ≥4 points in NIHSS score 14 days after treatment was higher in the thrombolytic group than that in the non thrombolytic group.The ratio of cases with 0 2 point in MRS score 90 days and 1 year after treatment was higher in the thrombolytic group than that in the non thrombolytic group.The difference was statistically significant. Conclusion The results of this study suggest that rt -PA intravenous thrombolysis within 4.5 hours of cerebral infarction in anterior choroidal artery did not reduce the incidence of progressive stroke,but its short term and long term prognosis was better.

关 键 词：脑梗死 阿替普酶 静脉溶栓 脉络膜前动脉 进展性卒中 

分 类 号：R743.33[医药卫生—神经病学与精神病学]