DWI-FLAIR不匹配指导阿替普酶静脉溶栓治疗不明发病时间的急性缺血性脑卒中的有效性及安全性分析  

Analysis of the Effectiveness and Safety of Alteplase Intravenous Thrombolysis in Acute Ischemic Stroke with Unknown Onset Time Based on DWI-FLAIR Mismatch

作　　者：程国辉 覃伟辉 吴桂洪 梁玉婵[2] 邓永杰 黄传芝[1] CHENG Guohui;QIN Weihui;WU Guihong;LIANG Yuchan;DENG Yongjie;HUANG Chuanzhi(Department of Neurology,Guangning County People's Hospital,Guangning,Guangdong Province,526300 China;Department of Neurology,Zhaoqing First People's Hospital,Zhaoqing,Guangdong Province,526000 China)

机构地区：[1]广宁县人民医院神经内科,广东广宁526300 [2]肇庆市第一人民医院神经内科,广东肇庆526000

出　　处：《世界复合医学》2023年第9期39-42,共4页World Journal of Complex Medicine

基　　金：肇庆市科技计划项目(2021040307016)。

摘　　要：目的分析阿替普酶静脉溶栓治疗DWI-FLAIR不匹配指导发病时间不明的急性缺血性脑卒中的有效性及安全性。方法回顾性分析2021年3月—2023年6月广宁县人民医院收治的60例经影像学及临床症状检查确诊为急性缺血性脑卒中患者的临床资料,根据发病时间是否明确将其分为发病时间不明组与发病时间明确组,每组30例。均选用重组组织型纤溶酶原激活剂阿替普酶(recombinant tissue plasminogen activator,rt-PA)进行静脉溶栓治疗。对比两组患者的临床疗效及溶栓后出血情况和预后效果。结果治疗前后两组患者的美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分比较,差异无统计学意义(P>0.05);两组治疗前后改良Rankin评分(Modified Rankin Scale,MRS)比较,差异无统计学意义(P>0.05);两组溶栓后不良事件发生率分别为6.67%和10.00%,差异无统计学意义(χ^(2)=0.000,P>0.05)。结论rt-PA溶栓治疗发病时间不明的急性缺血性脑卒患者中同治疗发病时间明确的患者效果相似。Objective To study the effectiveness and safety of intravenous thrombolysis with alteplase in DWI-FLAIR mismatch guidance for acute ischemic stroke with unknown onset time.Methods The clinical data of 60 patients with acute ischemic stroke admitted to Guang Ningxian People's Hospital from March 2021 to June 2023 were retrospectively analyzed.According to whether the onset time was clear or not,they were divided into unknown onset time group and clear onset time group,with 30 cases in each group.Recombinant tissue plasminogen activator(rt-PA)was used for intravenous thrombolytic treatment.The clinical treatment effects of the two groups of patients were compared,as well as the bleeding conditions and prognostic effects after thrombolysis.Results There was no statistically significant difference with the National Institute of Health Stroke Scale(NIHSS)score data before and after treatment between the two groups(P>0.05);compared the Modified Rankin Scale(MRS)score before and after treatment in the two groups,the difference was not statistically significant(P>0.05).The incidence of adverse events after thrombolysis in the two groups was 6.67%and 10.00%,and the difference was not statistically significant(χ^(2)=0.000,P>0.05).Conclusion Intravenous injection of recombinant tissue plasminogen activator(rt-PA)thrombolytic therapy can treat acute ischemic stroke with unknown onset time and has similar effects to patients with clear onset time.

关 键 词：DWI-FLAIR不匹配 发病时间不明 急性脑缺血性脑卒 阿替普酶静脉溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]