[1]王鹏,吉训明,罗玉敏,等.８８例缺血性脑卒中患者动脉溶栓治疗回顾性研究[J].介入放射学杂志,2007,(05):299.
　WANG Peng,JI Xun-ming,LUO Yu-min,et al.Retrospective analysis of intraarterial thrombolysis in８８patients with acute ischemic stroke[J].journal interventional radiology,2007,(05):299.
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８８ 例缺血性脑卒中患者动脉溶栓治疗回顾性研究()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2007年05期
页码:
299
栏目:
神经介入
出版日期:
2007-05-15

文章信息/Info

Title:
Retrospective analysis of intraarterial thrombolysis in８８patients with acute ischemic stroke
作者:
王鹏; 吉训明; 罗玉敏; 等
１０００５３北京首都医科大学宣武医院介入中心
Author(s):
WANG Peng; JI Xun-ming; LUO Yu-min; XUAN Yun; LI Ke; LI Da-lei; LING Feng．
Department of Interventional Radiology，Xuanwu Hospital，Capital University of Medical Science，Beijing１０００５３，China
关键词:
动脉溶栓; 急性缺血性脑卒中; 回顾性研究
分类号:
R７４３.４
文献标志码:
A
摘要:
目的总结动脉溶栓治疗的影响因素，为动脉内溶栓治疗的合理应用提供理论依据。方法通过回顾我中心８８例急性缺血性脑卒中动脉内溶栓治疗住院病例，采集患者病史、起病过程的特点、发病与动脉溶栓的间隔时间、有无出血、是否死亡以及治疗之后（包括治疗后即刻、治疗后２４h）患者主要神经功能的变化过程，我们所选用的神经功能包括肌力、眼震及意识水平。脑血管造影回顾则采集动脉溶栓前后DSA血管形态的异常发现及变化，以及尿激酶用量。此后对上述指标进行整理，统计学处理。结果本组患者，平均溶栓时间为５．８（５．８±３．３）h；DSA资料丢失２０例，造影阴性率为１４．７％，血管再通率（部分及完全再通）为３６．２％，溶栓后早期（＜２４h）症状加重２４例（２７．３％）。起病后６h内接受动脉内溶栓的急性缺血性脑卒中患者在治疗后２４h内加重率为３１．７％，与６h以上接受治疗者相比（１８．５％）有明显差异（P＝０．０１）；而与年龄、起病特点、溶栓后神经功能评分及血管造影结果及血管再通率间均无统计学差异。结论在不分辨前后循环所有患者群体内，急性脑缺血性脑卒中的动脉溶栓时间窗可以延长至６h，却面临更高的早期加重率。所以对于早期加重的原因揭示及有效处理，可以改善动脉溶栓的治疗效果。

参考文献/References:

［１］Adams JH，TOAST Investigators．Classification of subtype of acute ischemic stroke：Definitions for use in a multicenter clinical trial［J］．Stroke，１９９３，２４，３５-４１．
［２］Lisboa RC．Analysis of the safety and efficacy of intra-arterial thrombolytic therapy in ischemic stroke［J］．Stroke，２００２，３３：２８６６-２８７１．
［３］NINDS rt-PA Stroke Study Group．Tissue plasminogen activator for acute ischemic stroke［J］．N Engl J Med，１９９５，３３３：１５８１-１５８７．
［４］Del Zeppo GJ．PROACT：a phase II randomized trial of reco-mbinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke：PROACT investigators：Prolyse in acute cerebral thromboembolism［J］．Stroke，１９９８，２９：４-１１．
［５］Furlan A．Intra-arterial prourokinase for acute ischemic stroke：the PROACT II Study：a randomized controlled trial：Prolyse in acute cerebral thromboembolism［J］．JAMA，１９９９，２８２：２００３-２０１１．
［６］Saurez JI．Predictors of clinical improvement，angiographic rec-analization，and intracranial hemorrhage after intra－arterial thrombolysis for acute ischemic stroke［J］．Stroke，１９９９，３０：２０９４-２１００．
［７］Alexandrov AV．Ischemic stunning of the brain：Early rec-analiz-ation without immediate clinical improvement in acute ischemic stroke［J］．Stroke，２００４，３５：４４９-４５２．
［８］Lindsberg PJ．Thrombolysis for acute stroke［J］．Curr opin neu-rology，２００３，１６：７３-８０．

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备注/Memo

备注/Memo:
收稿日期：２００７-０３-０５
更新日期/Last Update: 2007-05-15