【摘要】 目的 证明重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗急性脑梗死的疗效及安全性。方法 60例符合入选标准的急性脑梗死患者分为静脉溶栓组和对照组，各30例。静脉溶栓组给予rt-PA总量0.9mg/kg,最大剂量90mg。10%剂量一次注入，其余1.5h静脉滴入；次日经头颅CT证实无出血者，用低分子肝素(速避凝4100U或法安明5000U)，每12h腹部皮下注射1次，连续7天；对照组应用低分子右旋糖酐500ml静滴，每日1次，连用8天。采用欧洲卒中量表(ESS)、Barthel指数(BI)评价神经功能恢复状况。结果 溶栓组疗效明显优于对照组(P<0.05)，静脉溶栓组颅内出血2例，对照组颅内出血2例，2组均无死亡病例。结论 rt-PA静脉溶栓治疗急性脑梗死(发病6h内)安全有效。

     【关键词】 重组组织型纤溶酶原激活物；溶栓；急性脑梗死

    Study on effect of r-tPA thrombolytic therapy for acute cerebral infarction

    NIE Wei,WANG Tong-yu,JIANG Sheng.Department of Neurology,Bohai Oil Hosptial,Tianjin 300452,China

    【Abstract】 Objective To investigate the efficacy and safety of intravenous recombinant tissue plasminogen activator(rt-PA)for patients with acute cerebral infarction.Methods 60 patients consistent with the inclusion criteria were divided into intravenous thrombolysis group and control group.rt-PA was administered in a dose of 0.9mg/kg(maximum does 90 mg)with 10% as a constant infusion over a period of 90 minutes in intravenous thrombolysis group.24 hours late,both group received only routine treatment.European Stroke Scale(ESS)and Barthel Index(BI)were used to evaluate the recovery of neurological functions.Results The efficacy in thrombolysis group was significantly higher than that in the control group(all P<0.05).Two cases of hemorrhagic infarction were found in intravenous thrombolysis group and control group respectively.No dead case was found in the both groups.Conclusion Thrombolytic therapy of intravenous rt-PA can be perform safely and efficaciously in patients with acute cerebral infarctrion within 6 hours from the onset. ......