【摘要】 目的探析急性缺血性脑卒中(acute ischemic stroke,AIS)溶栓治疗中参数优化MRI的应用有效性和临床指导意义。材料与方法采取回顾性对照研究法,选取2018年3月至2020年3月河西学院附属张掖人民医院神经内科接治的112例AIS患者作为研究对象,其中2018年3月至2019年2月接治的54例患者纳入对照组,2019年3月至2020年3月接治的58例患者纳入研究组;均以头颅MRI为首选影像检查,接受静脉溶栓治疗,对照组采取常规MRI检查,研究组采取参数优化MRI检查,对比两组入院到MRI时间(door-to-imaging time,DIT)、MRI到溶栓治疗时间(imaging-to-needle time,INT)、MRI检查用时、发病到溶栓时间(onset-to-needle time,ONT)及到院至溶栓时间(door-to-needle time,DNT),并统计治疗前MRI检查率、DNT<60 min比例、出院时mRS评分0～2分比例及症状性脑出血和死亡的发生情况。结果研究组ONT、INT、MRI检查用时、DIT、DNT分别为(178.56±39.20) min、(30.15±5.24) min、(5.30±0.42) min、(26.91±5.72) min、(58.31±10.47) min,对照组分别为(204.13±35.29) min、(43.48±12.80) min、(10.08±1.04) min、(49.04±12.55) min、(87.20±23.92) min,相比差异均有统计学意义(P<0.05)。研究组治疗前接受MRI检查率为81.03%,DNT<60 min占67.24%,出院时mRS评分0～2分占60.34%,对照组分别为61.11%、14.81%、44.44%,差异有统计学意义(P<0.05);而症状性脑出血率(1.72%VS 3.52%)、死亡率(1.72%VS3.52%)无明显差异(P>0.05)。结论参数优化MRI能为AIS发病时间在4.5 h内患者溶栓治疗提供良好指导,有效缩短入院到溶栓各环节用时,提高临床救治效率,可作为首选检查方法。更多还原

【Abstract】 Objective: To explore the efficacy and clinical significance of parametric optimal MRI in the thrombolytic therapy of acute ischemic stroke(AIS). Materials and Methods: Control study was used. All the 112 cases of AIS patients admitted to the department of neurology of Zhangye People’s Hospital Affiliated to Hexi University from March 2018 to March 2020 were selected as the research objects. Among them, 54 cases of AIS patients admitted from March 2018 to February 2019 were included in the control group, and58 cases of AIS patients admitted from March 2019 to March 2020 were included in the study group. The head MRI was the preferred imaging examination, and intravenous thrombolysis was performed in the control group, conventional MRI examination was performed in the control group, and parameter optimization MRI examination was performed in the research group. The two groups were compared in terms of the time from admission to MRI(DIT), MRI to imaging to needle time(INT), MRI examination time, and onset to needle time(ONT), door-to-needle time(DNT), and the rate of MRI examination before treatment, DNT<60 min ratio, mRS score 0—2 at discharge, and the occurrence of symptomatic cerebral hemorrhage and death.Results: In the study group, ONT, INT, MRI examination time, DIT and DNT were(178.56±39.20) min,(30.15±5.24) min,(5.30±0.42) min,(26.91±5.72) min,(58.31±10.47) min, respectively.The control group was(204.13±35.29) min,(43.48±12.80) min,(10.08±1.04) min,(49.04±12.55) min, and(87.20±23.92) min,respectively, with statistically significant differences(P<0.05). Before treatment, 81.03% of the study group received MRI examination,DNT<60 min accounted for 67.24%, and mRS score of 0—2 accounted for 60.34% at discharge, while the control group was 61.11%,14.81%, and 44.44%, respectively. The difference was statistically significant(P<0.05). However, there was no significant difference between symptomatic cerebral hemorrhage rate(1.72% VS 3.52%) and mortality rate(1.72% VS 3.52%)(P>0.05).Conclusions: Optimization of MRI can provide good guidance for thrombolytic therapy of AIS patients within 4.5 h, effectively shorten the time from admission to thrombolytic therapy, and improve the efficiency of clinical treatment. Therefore, MRI can be used as the preferred examination method.更多还原