| 贾麾 李严培 田沈 周环 高连波.多模式磁共振指导超时间窗急性缺血性卒中的静脉溶栓治疗研究[J].,2015,15(14):2677-2680 |
| 多模式磁共振指导超时间窗急性缺血性卒中的静脉溶栓治疗研究 |
| Research on the Intravenous Thrombolytic Therapy for Acute IschemicStroke extended Time Window by Multimode MRI |
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| DOI： |
| 中文关键词: 静脉溶栓 超时间窗 多模式磁共振 急性缺血性卒中 |
| 英文关键词: Thrombolysis Extended time window Multimode MRI Acute Ischemic Stroke |
| 基金项目:辽宁省沈阳市科学技术项目（F12-193-9-34） |
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| 中文摘要: |
| 目的：评价多模式磁共振指导下超时间窗静脉应用重组组织型纤溶酶原激活剂rtPA 治疗急性缺血性卒中的疗效及安全性。
方法：将68 例急性脑梗塞患者分为rtPA静脉溶栓组A 组、强化抗栓治疗组B 组，各组按药物干预时间再分为<4.5 小时亚组及
4.5-6 小时亚组。A 组给予rtPA 静脉溶栓治疗和常规治疗，B 组给予首剂氯吡格雷300 毫克+阿司匹林100 毫克和常规治疗。治
疗前行急诊头多模式磁共振检查，治疗24小时后复查头CT，分别于治疗前后不同时间点进行NIHSS 评分和3 个月MRS 评分，
记录不良事件的发生情况。结果：A 组两个亚组治疗后各时间点NIHSS 评分均明显低于B 组，且A 组<4.5 小时亚组治疗后
NIHSS 评分低于其4.5-6小时亚组，A组3 个月预后良好患者比例显著高于B 组，差异均有统计学意义（P<0.05）。A 组症状性颅
内出血的发生率高于B 组。结论：多模式头磁共振指导下超时间窗rtPA静脉溶栓治疗安全有效，远期疗效优于强化抗栓治疗，但
颅内症状性出血风险略高于强化抗栓治疗。 |
| 英文摘要: |
| Objective:To investigate the efficacy and safety of extending thrombolytic time window of recombinant tissue-type
plasminogen activator (rtPA) in the therapy of acute ischemic stroke by multimode MRI.Methods:68 patients were divided into rtPA
group (group A) with intravenous injection of rtPA (0.9 mg/kg) and normal drugs and routine group (group B) with normal drugs. Each
group was divided into two subgroups depending on the onset time. Head CT/multimode MR and NIHSS/MRS were assessed before and
after treatment. The incidence of adverse reactions were recorded.Results:The NIHSS scores at each time point after treatment were
significantly lower in two subgroups of group A than those of groupB (P<0.05). The NIHSS score of less than 4.5h onset group was
evidently lower than that of 4.5-6h group in group A(P<0.05). The percentage of better outcome patients was higher in group A than that
in group B (P<0.05). Group A had higher risk of symptomatic intracranial hemorrhage than group B.Conclusion:Intravenous
thrombolytic therapy for acute ischemic stroke extended time window by multimode MRI was safety and efficacy, which had better
long-termresults than routine therapy, but with higher risk of symptomatic intracranial hemorrhage. |
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