CAJ | 학술논문

目的：探讨应用局部亚低温延长急性脑梗死溶栓治疗时间窗的疗效及安全性。方法：选择63例发病6～12小时通过多模式MRI筛选符合溶栓条件的脑梗死患者，随机分为亚低温组、溶栓组及对照组，亚低温组同时给予局部亚低温及尿激酶溶栓治疗，溶栓组给予尿激酶溶栓治疗，3组常规治疗相同，比较治疗前及治疗后24小时、14天、90天NIHSS评分及总有效率。结果：亚低温组及溶栓组治疗后14天及90天NIHSS评分明显减少（P＜0．05），亚低温组90dNIHSS评分低于溶栓组（P＜0．05），但2组间总有效率比较无显著性差异（ P＞0．05）。结论：局部亚低温治疗患者远期疗效优于单纯溶栓组，在多模式MRI筛选下，一些超出目前规定时间窗的患者可以从溶栓治疗中获益，而不增加出血转归，局部亚低温是否有助于延长溶栓时间窗有待于进一步大样本的研究。
목적：탐토응용국부아저온연장급성뇌경사용전치료시간창적료효급안전성。방법：선택63례발병6～12소시통과다모식MRI사선부합용전조건적뇌경사환자，수궤분위아저온조、용전조급대조조，아저온조동시급여국부아저온급뇨격매용전치료，용전조급여뇨격매용전치료，3조상규치료상동，비교치료전급치료후24소시、14천、90천NIHSS평분급총유효솔。결과：아저온조급용전조치료후14천급90천NIHSS평분명현감소（P＜0．05），아저온조90dNIHSS평분저우용전조（P＜0．05），단2조간총유효솔비교무현저성차이（ P＞0．05）。결론：국부아저온치료환자원기료효우우단순용전조，재다모식MRI사선하，일사초출목전규정시간창적환자가이종용전치료중획익，이불증가출혈전귀，국부아저온시부유조우연장용전시간창유대우진일보대양본적연구。
Objective:To explore the curative effect and safety of local mild hypothermia treatment to extend time window of thrombo -lytic of acute cerebral infarction on multi -modality magnetic resonance imaging ( MRI) -based.Methods: According to thrombolysis conditions based on MRI,63 cerebral infarction patients (6 to 12 hours between) were chosen.They were randomized into 3 groups,local mild hypothermia group ,thrombolysis group and control group respectively .All patients were given conventional therapy .The urokinase thrombolysis treatment and local mild hypothermia were used in first groups and the thrombolysis treatment in second group .Compared the National Institutes of Health Stroke Scale (NIHSS) score and the total effective rate before,and 24h,14d and 90d after treatment.Re-sults:The 14d and 90d NIHSS score of local mild hypothermia group and thrombolysis group decreased significantly (P<0.05).The 90d NIHSS score of local mild hypothermia group was lower than thrombolysis group ( P<0.05) .The total effective rate of two groups had no big difference (P>0.05).Conclusion:Based on MRI,many patients which are beyond the specified time window benefit from thrombol-ysis treatment .The long-term curative effect of local mild hypothermia treatment should be better than thrombolysis treatment only .