CAJ | 학술논문

目的了解在MRI指导下对轻症和症状迅速缓解的急性脑梗死患者行静脉溶栓治疗的安全性和有效性。方法2010年4月至2012年5月，在MRI指导下对我院轻症和症状迅速缓解的急性脑梗死患者进行静脉溶栓治疗。观察并记录溶栓患者的基线临床特征、影像学表现、90 d时的临床转归，并将其与我院同期NIHSS＞4分溶栓患者及国外公开发表的同类研究结果进行比较。结果本组共计23例轻症和症状迅速缓解的急性脑梗死患者进行了静脉溶栓治疗，占同期溶栓患者总数的21.3％（23/108）。患者中存在大动脉严重狭窄或闭塞者8例（35％），其中5例伴有灌注损害；幕下病变者6例（26％）。溶栓后90 d时结局为可独立行动（改良Rankin评分0～2分）患者21例（91％）、非症状性颅内出血1例（4.4％），无死亡病例，明显优于本院同期 NIHSS ＞4分溶栓患者的结局（ P ＜0.01）。与国外其他同类研究的临床结局相近。结论在MRI指导下对轻症和症状迅速缓解脑梗死患者进行静脉溶栓治疗是安全、有效的。
목적료해재MRI지도하대경증화증상신속완해적급성뇌경사환자행정맥용전치료적안전성화유효성。방법2010년4월지2012년5월，재MRI지도하대아원경증화증상신속완해적급성뇌경사환자진행정맥용전치료。관찰병기록용전환자적기선림상특정、영상학표현、90 d시적림상전귀，병장기여아원동기NIHSS＞4분용전환자급국외공개발표적동류연구결과진행비교。결과본조공계23례경증화증상신속완해적급성뇌경사환자진행료정맥용전치료，점동기용전환자총수적21.3％（23/108）。환자중존재대동맥엄중협착혹폐새자8례（35％），기중5례반유관주손해；막하병변자6례（26％）。용전후90 d시결국위가독립행동（개량Rankin평분0～2분）환자21례（91％）、비증상성로내출혈1례（4.4％），무사망병례，명현우우본원동기 NIHSS ＞4분용전환자적결국（ P ＜0.01）。여국외기타동류연구적림상결국상근。결론재MRI지도하대경증화증상신속완해뇌경사환자진행정맥용전치료시안전、유효적。
Objective To evaluate safety and efficacy in magnetic resonance imaging ( MRI ) guided thrombolysis for acute ischemic stroke patients with mild or rapidly improving symptoms .Methods Patients presenting with mild or rapidly improving symptoms were treated with thrombolysis based on MR imaging between April 2010 and May 2012 in our hospital .Baseline clinical features ,MR imaging findings and outcomes after 90 days were extracted and analyzed .Clinical outcomes were also compared with other exploratory off-label thrombolysis studies and the rest of lytic patients with NIHSS score more than 4 in our hospital during the same period . Results Of a total of 108 lytic patients,23(21.3%)with mild or rapidly improving symptoms were treated .Large arterial occlusion or severe stenosis was found in 8 cases(35%)and hypoperfusion was confirmed in 5 among them. Subtentorial infaction were clarified in 6 patients ( 26%) .In clinical outcomes ,21 patients ( 91%) were independent at three-months( modified Rankin scale 0-2) and only one asymptomatic intracranial haemorrhage was observed .No one died in this study .The outcome results were more better than our other lytic patients with NIHSS score more than 4(P<0.01)and were comparable to those in other off-label studies.Conclusion Our data demonstrate that MRI-guided thrombolysis in stroke patients with mild or rapidly improving symptoms is safe and effective .