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目的探讨重组组织型纤溶酶原激活剂(rt-PA)治疗急性心源性脑栓塞(CCE)的安全性及疗效。方法符合入选标准的患者溶栓组19例,对照组21例,发病3h内给予rt-PA(0.9 mg/kg)静脉溶栓治疗,采用美国国立卫生院神经功能缺损评分及Barthel指数,评定溶栓前及溶栓后2、6 h、1、3、7、30、90 d的疗效及安全性。结果溶栓后各时间点NIHSS评分均有显著改善(P<0.05),溶栓组临床总有效率89.5%,对照组38.1%。溶栓组脑出血发生率为10.5%,其中症状性脑出血发生率5.26%。对照组脑出血发生率19%,其中症状性脑出血发生率4.76%。溶栓组病死率0,对照组病死率9.5%。结论 CCE患者3 h内给予rt-PA静脉溶栓治疗是安全有效的。
Objective To investigate the safety and efficacy of recombinant tissue plasminogen activator (rt-PA) in the treatment of acute cardioembolic infarction (CCE). Methods Twenty-nine patients in the thrombolysis group and 21 in the control group were given intravenous thrombolysis with rt-PA (0.9 mg / kg) within 3 hours after the onset of symptoms. The neurological deficit score and Barthel index of the National Institutes of Health were evaluated. Efficacy and safety of prethrombolytic therapy and 2,6 h, 1,3,7,30,90 d after thrombolysis. Results The scores of NIHSS at all time points after thrombolysis were significantly improved (P <0.05). The total clinical effective rate was 89.5% in the thrombolytic group and 38.1% in the control group. The incidence of cerebral hemorrhage in the thrombolytic group was 10.5%, and the incidence of symptomatic intracerebral hemorrhage was 5.26%. The incidence of cerebral hemorrhage in the control group was 19%, and the incidence of symptomatic intracerebral hemorrhage was 4.76%. Thrombolytic group mortality 0, the control group mortality 9.5%. Conclusions Intravenous thrombolysis with rt-PA within 3 h of CCE is safe and effective.