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目的:探讨重组组织型纤溶酶原激活剂(rt-PA)3小时以内静脉溶栓治疗再发性脑梗死的疗效及安全性。方法:对26例发病3小时以内的再发性脑梗死患者给予rt-PA(0.9mg/kg)静脉溶栓治疗;溶栓前及溶栓后24h、7d、14d及90d时分别采用美国国立卫生院卒中量表(NIHSS)评分,溶栓前及溶栓后90d给予日常生活能力Barthel指数(BI)评分,评价其疗效;同时临床观察其安全性。结果:溶栓后各时间点NIHSS评分较溶栓前相比差异有极显著统计学意义(均P<0.01);90d时BI评分较溶栓前相比差异有极显著统计学意义(均P<0.01);脑出血3例,其中1例死亡。结论再发性脑梗死3小时以内应用rt-PA静脉溶栓治疗相对安全有效。
Objective: To investigate the efficacy and safety of intravenous thrombolysis in the treatment of recurrent cerebral infarction within 3 hours with recombinant tissue plasminogen activator (rt-PA). Methods: Twenty-six patients with recurrent cerebral infarction within 3 hours of onset were given rt-PA (0.9 mg / kg) intravenous thrombolysis. Before the thrombolysis and at 24h, 7d, 14d and 90d after thrombolysis, National Institutes of Health Stroke Scale (NIHSS) score, Barthel index (BI) score before daily thrombolytic therapy and 90 days after thrombolysis were evaluated to evaluate its efficacy. At the same time, its safety was observed clinically. Results: The NIHSS score at each time point after thrombolysis was significantly different from that before thrombolysis (all P <0.01). There was significant difference in BI score at 90 days before thrombolysis (P <0.01); 3 cases of intracerebral hemorrhage, of which 1 case died. Conclusions Intravenous thrombolysis with rt-PA within 3 hours of recurrent cerebral infarction is relatively safe and effective.