【摘要】 目的分析早期静脉溶栓对急性轻型缺血性卒中患者的临床疗效.方法收集神经功能缺损(NIHSS)评分≤5分且症状发作3 h内的缺血性卒中患者110例,根据治疗方案将其分为静脉溶栓组(55例)和常规治疗组(55例).所有患者治疗后均进行NIHSS评分及神经功能恢复状况的mRS评分;计算患者颅内出血率和死亡率.结果两组患者24 h、14 d的NIHSS评分静脉溶栓组患者均较常规治疗组评分降低;两组患者颅内出血、死亡事件发生率及90 d的mRS评分总体预后良好,差异无统计学意义(P>0.05),但是伴有颅内大动脉狭窄并进行rtPA静脉溶栓的患者与常规治疗组比较90 d预后良好,差异具有统计学意义(P<0.05).结论轻型缺血性卒中患者急性期应用静脉溶栓治疗安全有效,尤其是伴有颅内大动脉狭窄的患者其临床获益更大.更多还原

【Abstract】 Objective To analyze the efficacy of early intravenous thrombolysis in patients with acute mild ischemic stroke.Method 110 patients of ischemic stroke with a NIHSS score ≤5 and within 3 h symptom onset were collected and divided into intravenous thrombolytic group(55 cases) and conventional treatment group(55 cases) according to the treatment mode. NIHSS score and mRS score of neurological function recovery were performed in all patients after treatment. Intracranial hemorrhage rates and mortality rates were calculated.Results The NIHSS scores of the two groups at 24 h and 14 d were compared,and the scores of the intravenous thrombolysis group were lower than those of the conventional treatment group. The incidence of intracranial hemorrhage,death events and mRS score at 90 d in the two groups had a good overall prognosis,with no statistically significant difference(P > 0. 05). However,compared with the conventional treatment group,the patients with intracranial arterial stenosis and intravenous thrombolysis with rt-PA had a good prognosis at 90 d,and was statistically significant difference(P < 0.05). Conclusion Intravenous thrombolytic therapy is safe and effective in the acute stage of mild ischemic stroke,especially in patients with intracranial arterial stenosis.更多还原