【摘要】 目的 探讨重组组织型纤溶酶原激活剂(rtPA)超声增强溶栓联合强化降压治疗老年急性脑梗死(ACI)的临床效果及对预后转归的影响。方法 收集我院200例老年ACI患者，根据入院接受治疗时间分成对照组88例和观察组112例，对照组给予rtPA标准溶栓联合强化降压，观察组给予rtPA超声增强溶栓联合强化降压。记录两组血脂、神经功能及生活质量的变化，并对预后转归情况进行评价。结果 治疗后观察组总胆固醇(TC)、甘油三酯(TG)、卒中量表(NIHSS)评分低于对照组，巴塞尔指数(Barthel指数)高于对照组(P<0.05);观察组转归良好率及血管再通率高于对照组，出血转化率低于对照组(P<0.05)。结论 临床治疗以rtPA超声增强溶栓联合强化降压治疗为主，可有效改善老年ACI患者调脂效果及神经功能，还能提高转归良好率及血管再通率，对于促进生活能力的恢复也具有重要作用，值得临床推荐使用。更多还原

【Abstract】 Objective To investigate the clinical effect of ultrasound-enhanced thrombolysis using recombinant tissue-type plasminogen activator(rtPA) combined with intensive antihypertensive treatment in elderly patients with acute cerebral infarction(ACI) and the influence on prognosis of the patients.Methods A total of 200 elderly patients with ACI were selected. The patients were divided into a control group(n=88) and an observation group(n=112). The control group received standard thrombolysis using rtPA combined with intensive antihypertensive treatment and the observation group received ultrasound-enhanced thrombolysis using rtPA combined with intensive antihypertensive treatment. Changes of blood lipids, neurological function and quality of life in the two groups were recorded, and the prognosis was evaluated.Results After treatment, the levels of total cholesterol(TC) and triglycerides(TG) and NIHSS score were lower, and Barthel index score was higher in the observation group than those in the control group(P<0.05). The good prognosis rate and vascular recanalization rate were higher and the hemorrhagic transformation rate was lower in the observation group than those in the control group(P<0.05).Conclusions Clinical treatment is mainly based on rtPA ultrasound-enhanced thrombolysis combined with intensive antihypertensive therapy. The therapy can effectively improve the lipid-lowering effect and neurological function of elderly patients with ACI. It can improve the rate of good outcome and vascular recanalization rate. It also plays an important role in promoting the recovery of living ability. It is worthy of clinical recommendation.更多还原