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目前认为动脉内溶栓的组织型纤溶酶原激活剂(t-PA)剂量不能超过静脉溶栓t-PA的剂量应<60mg,甚至降至20mg,但这些剂量缺乏直接的临床证据。最近美国公布的一项研究,首次报道使用高达100mg t-PA进行动脉溶栓,并评估了溶栓后的出血率、临床及影像学结果。该研究为单中心前瞻性研究,连续纳入的67例急性脑梗死患者均符合PROACT研究的标准,溶栓靶血管涉及大脑中动脉M1段、颈内动脉颅内段及基底动脉。t-PA注射速度
It is currently thought that the dose of intra-arterial thrombolysis of tissue-type plasminogen activator (t-PA) should not exceed the dose of intravenous thrombolytic t-PA should be <60mg, or even reduced to 20mg, but the lack of direct clinical evidence of these doses. A recent study published in the United States reported for the first time the use of arterial thrombolysis with up to 100 mg t-PA and the bleeding rate after thrombolysis, clinical and radiographic findings. This single-center, prospective study of 67 consecutive patients with acute cerebral infarction met PROACT criteria. The target vessel for thrombolysis involved the middle cerebral artery M1 segment, the internal carotid artery segment, and the basilar artery. t-PA injection speed