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目的探讨mRS评分和NIHSS评分对重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓对急性脑梗死(ACI)的评价价值。方法选取93例拟行溶栓治疗的ACI患者作为研究对象,随机分为对照组(n=45)和研究组(n=48)。对照组患者采用尿激酶溶栓治疗,研究组患者采用rt-PA溶栓治疗,对比两组患者治疗有效率、治疗前后mRS评分、NIHSS评分及并发症发生情况。结果研究组治疗有效率(97.92%)高于对照组(86.67%)(P<0.05)。治疗前两组mRS评分对比无统计学差异,治疗后14 d与治疗前比较仍无统计学差异(P>0.05);治疗后28 d与治疗前比较有显著性差异(P<0.05),且研究组显著低于对照组(P<0.05)。治疗前两组患者NIHSS评分未见明显差异,治疗后两组患者NIHSS评分均有所改善(P<0.05),研究组治疗后24 h、7 d、14 d均显著低于对照组(P<0.05)。研究组并发症发生率(8.33%)显著低于对照组(26.67%),差异均有显著性(χ2=8.437,P<0.05)。结论按照溶栓指南进行规范化操作和严格掌握溶栓适应证,发病4.5 h内给ACI患者进行rt-PA静脉溶栓可明显提高临床疗效,改善mRS评分和NIHSS评分。
Objective To investigate the value of mRS score and NIHSS score in evaluating acute cerebral infarction (ACI) by intravenous thrombolysis of recombinant tissue plasminogen activator (rt-PA). Methods Ninety-three ACI patients undergoing thrombolytic therapy were randomly divided into control group (n = 45) and study group (n = 48). Patients in the control group were treated with urokinase thrombolysis. Patients in the study group were treated with rt-PA thrombolytic therapy. The treatment efficiency, mRS score, NIHSS score and complications before and after treatment were compared between the two groups. Results The effective rate of the study group (97.92%) was higher than that of the control group (86.67%) (P <0.05). There was no significant difference in the mRS score between the two groups before treatment, but there was no significant difference between the two groups (P> 0.05) on the 14th day after treatment. There was a significant difference between the two groups on the 28th day after treatment (P <0.05) The research group was significantly lower than the control group (P <0.05). There was no significant difference in the NIHSS scores between the two groups before treatment, and the NIHSS scores of the two groups improved after treatment (P <0.05). The levels of NIHSS in the two groups were significantly lower than those of the control group 24 h, 7 d and 14 d after treatment (P < 0.05). The incidence of complications in the study group (8.33%) was significantly lower than that in the control group (26.67%), the difference was significant (χ2 = 8.437, P <0.05). Conclusion According to thrombolytic guidelines for standardized operation and strict control of thrombolytic indications, within 4.5 h of onset of ACI in patients with rt-PA intravenous thrombolysis can significantly improve the clinical efficacy, improve the mRS score and NIHSS score.