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目的探讨静脉溶栓治疗急性缺血性脑卒中时假卒中的临床特征及其鉴别。方法回顾性分析第二军医大学长海医院2013年9月至2015年2月静脉溶栓、明确诊断假卒中患者的临床资料,并与缺血性脑卒中患者进行比较,分析两组患者临床表现与实验室检查结果的差异。结果静脉溶栓患者212例,明确假卒中患者7例(3.3%),与缺血性脑卒中患者比较,两组患者基线数据无明显差异,精神心理障碍和痴呆病史对鉴别假卒中具有重要价值,头颅MRI、血管评估、脑电图、血液和脑脊液检查有助于明确假卒中的最后诊断。结论少数静脉溶栓治疗的患者最后诊断为假卒中,患者病史结合头颅MRI对鉴别诊断具有重要价值。
Objective To investigate the clinical characteristics and differential diagnosis of stroke in patients with acute ischemic stroke treated by intravenous thrombolysis. Methods A retrospective analysis of the clinical data of patients with pseudo-stroke diagnosed by intravenous thrombolysis in Changhai Hospital of Second Military Medical University from September 2013 to February 2015 was performed. The clinical data of patients with ischemic stroke were compared and analyzed. The clinical manifestations, Differences in laboratory test results. Results There were 212 cases of intravenous thrombolysis and 7 cases of stroke were identified (3.3%). Compared with ischemic stroke patients, there was no significant difference in baseline data between the two groups. The history of mental disorders and dementia was of great value in the identification of stroke , Cranial MRI, vascular assessment, electroencephalography, blood and cerebrospinal fluid tests can help clarify the final diagnosis of stroke. Conclusions A minority of thrombolytic therapy patients were finally diagnosed as false stroke. The history of patients combined with cranial MRI has important value in the differential diagnosis.