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目的：探讨不确定发病时间急性脑梗死在多模式核磁指导下动脉溶栓的临床疗效。方法选择40例发病时间不确定的急性脑梗死的患者，急诊行头颅核磁检查，包括T1、T2、DWI序列，并且T1、T2平扫正常， DWI高密度影。随机分成动脉溶栓组20例，术后20mg立普妥调脂，丹参注射液活血化瘀，脑复康注射液营养脑细胞等治疗，24 h复查CT，如无出血，给予100 mg拜阿司匹林抗血小板。20例为常规治疗组，给予100 mg拜阿司匹林抗血小板，20 mg立普妥调脂，丹参活血化瘀，脑复康营养脑细胞治疗。比较每组治疗前后14 d NIHSS评分有无显著性的差异，及两组间NIHSS治疗后14 d有无显著性的差异。结果动脉溶栓治疗组治疗前后有显著性的差异，两组之间比较差异有统计学意义（P＜0.05）。并且动脉溶栓组无脑出血并发症。结论对不确定发病时间的急性脑梗死的患者在多模式核磁指导下动脉溶栓效果显著，并且是安全的。“,”Objective To discuss the clinical efficacy of intra-arterial thrombolysis in patients with acute cerebral infarction of uncertain disease-time under the guide of cranial multimodel MRI. Methods 40 cases of acute cerebral infarction without certain time were recruited, emergency MR of the head were performed in all patients, the T1、T2、DWI sequence were scanned, the T1 and T2 scan is normal, but the DWI showed high density shadow.The patients were randomly divided into intra-arterial thrombolysis group and conventional treatment group, The intra-arterial thrombolysis group were given 20 mg Lipitor regulating lipid, Danshen injection improving blood circulation and Piracetam injection nourishing brain cells after operation, and the CT were reviewed after 24 h, if there was no blooding in the patients’head, we would give 100mg aspirin antiplatelet. The conventional group weren’t accepted intra-arterial thrombolysis, the patients were only given the 100 mg aspirin, 20mg Lipitor, Danshen injection and Piracetam injection after acute cerebral infarction, then NIHSS scores were assessed at 14 d of each group in pretherapy and post-treatment, and we also compared the NIHSS scores between the two groups after 14d. Results There were remarkable significance in pretherapy and post-treatment of the intra-arterial thrombolysis group(P<0.05), but also between the two groups after treatment(P<0.05), and there were no brain bleeding complications in intra-arterial thrombolysis group.Conclusion For patients with acute cerebral infarction of uncertain disease-time, the intra-arterial thrombolysis ,under the guide of cranial multimodel MRI, has significant effect and it is also safe.