摘要
目的探讨MR血管成像在指导急性缺血性脑卒中患者溶栓治疗的价值。方法回顾性分析MR血管成像（MRA）上存在大血管闭塞并符合重组组织型纤溶酶原激活剂（rt—PA）溶栓入选标准的65例患者的临床资料，在3～6h治疗时间窗内分别接受rt—PA溶栓治疗（溶栓组，38例）和常规治疗（未溶栓组，27例）。治疗3个月后随访2组改良的ranking量表（mRS）评分，通过卡方检验评价组间疗效分级，Mann—Whitney检验评价mRS评分，并与国外多中心研究的联合分析结果对照。结果治疗3个月后随访时，溶栓组和未溶栓组mRS评分为0～1分的比例分别为52．6％（20／38）和33．3％（9／27）（χ^2=3．858，P=0．049），mRS评分中位数分别为1和3分（U=－2．026，P=0．043），组间临床有效结局差异有统计学意义。结论MRA可以用于完善rt—PA溶栓治疗指征，存在大血管闭塞的急性缺血性脑卒中患者在超早期应给予rt—PA溶栓治疗。
Objective To evaluate the value of MR angiography in thrombolytic therapy of acute ischemic stroke. Methods According to inclusion criteria, 65 patients who also having large vessel occlusion were selected, and they were performed rt-PA treatment （38 patients） and routine treatment （27 patients） within 3---6 hours of onset of symptoms, respectively. Mann-Whitney U test and chi square test were performed to compare the clinical and MR imaging baseline index and the clinical outcome between the two groups respectively. Clinical outcome was assessed after 3 months using a dichotomized modified Rankin scale score. Data were also compared with the combined analysis of the ATLANTIS, ECASS, NINDS rt-PA trials. Results The difference of clinical outcome in 3 months between the two groups was significant （ P 〈 0. 05 ） and the median of the two group was 1 and 3, respectively. The ratio of favorable outcome （ mRS 0--1 ） in the two groups was 52. 6% （20/38） and 33. 3% （9/27）, respectively. Conclusion MR angiography plays an important role in thrombalytic therapy of acute ischemic stroke and it should be used to consummate the conventional inclusion criteria, the patients with large vessel occlusion should be treated by rt-PA.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2008年第7期697-701,共5页
Chinese Journal of Radiology
基金
国家“十五”科技攻关资助项目（2004BA714B06-02）
国家“十一五”科技攻关资助项目（2007BA105B07,2006BA101A11）
关键词
脑血管意外
血栓溶解疗法
磁共振成像
Cerebrovascular accident
Thrombolytic therapy
Magnetic resonance imaging
