浙江大学学报（医学版）2026，Vol.55Issue(2)：105-112,8.DOI:10.3724/zdxbyxb-2025-0730
轻型急性缺血性脑卒中患者静脉溶栓的有效性及安全性
Efficacy and safety of intravenous thrombolysis in patients with mild acute ischemic stroke
摘要
Abstract
Objective:To evaluate the efficacy and safety of intravenous thrombolysis in patients with mild acute ischemic stroke(AIS).Methods:In this retrospective cohort study,adult patients with mild AIS within 4.5 hours of onset between July 2009 and December 2024 were enrolled from four hospitals in Zhejiang province.Mild AIS was defined as a National Institutes of Health Stroke Scale(NIHSS)score≤5,with a limb motor NIHSS score of 0,and a NIHSS score≥2 in any of the following items:gaze,visual fields,facial palsy,limb ataxia,sensation,language,dysarthria,or neglect.Logistic regression and general linear models were used to assess the impact of intravenous thrombolysis on 3-month functional outcomes and safety endpoints.Results:Among 347 enrolled patients,206(59.4%)received intravenous thrombolysis.The proportion of patients achieving a favorable functional outcome(modified Rankin Scale score 0-1)at 3 months was significantly higher in the thrombolysis group than that in the non-thrombolysis group(76.2%vs.66.0%,adjusted OR=1.729,95%CI:1.016-2.940,P<0.05).The thrombolysis group also had a significantly lower all-cause mortality rate(1.0%vs.12.8%,adjusted OR=0.074,95%CI:0.015-0.379,P<0.01).Safety analysis showed hemorrhagic transformation in 5.8%,parenchymal hemorrhage in 1.9%,and symptomatic intracranial hemorrhage in 2.9%within 24 hours in the thrombolysis group,compared with 3.5%hemorrhagic transformation in the non-thrombolysis group,with no statistically significant differences between the two groups(all P>0.05).Conclusion:Intravenous thrombolysis can significantly improve 3-month functional outcomes and reduce mortality in patients with mild AIS,without increasing the risk of hemorrhagic transformation.关键词
急性缺血性脑卒中/轻型脑卒中/静脉溶栓/临床结局/安全性/回顾性研究Key words
Acute ischemic stroke/Mild stroke/Intravenous thrombolysis/Clinical outcomes/Safety/Retrospective study分类
医药卫生引用本文复制引用
李笑蓉,张旭婷,王安妮,王庭欢,严艺,傅晶晶,郑兢,楼敏,胡进..轻型急性缺血性脑卒中患者静脉溶栓的有效性及安全性[J].浙江大学学报（医学版）,2026,55(2):105-112,8.基金项目
浙江省基础公益研究计划(LY23H090011) （LY23H090011）
浙江省医药卫生科技计划(2021KY378) （2021KY378）
科技创新2030—重大项目(2022ZD0206000)This study was supported by Basic Public Welfare Research Program of Zhejiang Province (LY23 H090011),Medical and Health Science and Technology Project of Zhejiang Province (2021KY378),and STI2030-Major Projects (2022ZD0206000) （2022ZD0206000）
