中国卒中杂志2017，Vol.12Issue(4)：302-308,7.DOI:10.3969/j.issn.1673-5765.2017.04.003
经颅多普勒超声脑缺血溶栓分级与阿替普酶静脉溶栓治疗急性前循环不同大动脉闭塞性脑梗死预后相关性研究
摘要
Abstract
Objective To investigate and evaluate the intravenous thrombolytic therapeutic recanalization of acute ischemic stroke patients with different large vessel occlusion in the anterior circulation, and the association between thrombolysis in brain ischemia (TIBI) transcranial Doppler flow grades and the outcome of ischemic stroke patients. Methods Patients diagnosed as acute ischemic stroke with a proximal vessel occlusion in the anterior circulation were selected as subjects. Those who were able to receive intravenous thrombolysis were given alteplase intravenous thrombolysis therapy. Thrombolysis in brain ischemia (TIBI) flow grades of large vessels before and 24 h after thrombolysis were assessed by transcranial Doppler (TCD). National Institutes of Health Stroke Scale (NIHSS) was used to record the neurologic impairment of patients. The modified Rankin Scale (mRS) was used at 3 months follow-up to analyze the recanalization before and after thrombolysis of proximal vessel occlusion in the Anterior Circulation and 3-months prognosis. Results A total of 46 patients were included. There were 19 cases of internal carotid artery (ICA) occlusion and 27 cases of middle cerebral artery (MCA) occlusion. The 24 h TCD monitored TIBI before and after thrombolysis showed that the rates of recanalization of ICA occlusion group and MCA occlusion group were 5.26% and 55.56%, respectively. For the functional independence outcome at 90 days, MCA occlusion group was significantly better than ICA occlusion group. For excellent recovery outcome at 90 days, MCA occlusion group was also significantly better than ICA occlusion group. For mortality, MCA group was significantly lower than ICA group. There were no significant differences between MCA group and ICA group in the symptomatic intracranial hemorrhage. Conclusion The intravenous thrombolytic therapeutic recanalization of the acute ischemic stroke patients with large vessel occlusion in the anterior circulation was effective, in particular to patients with MCA occlusion. The changes of TIBI grade system blood flow grades before and after thrombolysis could reflect the status of recanalization, which is helpful in judging the clinical prognosis of patients.关键词
经颅多普勒超声/脑缺血溶栓分级/急性缺血性卒中/静脉溶栓/预后Key words
Transcranial Doppler/Thrombolysis in brain ischemia (TIBI)/Acute ischemic stroke/Thrombolysis/Prognosis引用本文复制引用
车锋丽,陈胜云,杨中华,赵性泉,杜会山,魏建朝,孟繁花,张伟东..经颅多普勒超声脑缺血溶栓分级与阿替普酶静脉溶栓治疗急性前循环不同大动脉闭塞性脑梗死预后相关性研究[J].中国卒中杂志,2017,12(4):302-308,7.基金项目
北京市医院管理局"登峰"人才培养计划(DFL20150501)北京市卫生系统高层次卫生技术人才培养计划"学科带头人"(2014-2-010)北京市科学技术委员会资助(Z161100002616008) （DFL20150501）
