关键词: 轻型缺血性脑卒中, 静脉溶栓, 重组组织型纤溶酶原激活剂

Abstract: Objective To observe the effectiveness and safety of intravenous thrombolysis with rt-PA in patients of acute mild ischemic stroke. Methods Retrospective analyze a total of 107 acute ischemic stroke patients with baseline NIHSS≤3 were enrolled in the study who hospitalized in Shanghai Jiading District Central Hospital from January 2021 to December 2021.Acco rding to whether performing intravenous thrombolysis or not, 107 patients were divided into intravenous thrombolysis group(n=49) and non-venous thrombolysis group(n=58).The baseline and clinical data were recorded for both groups and their differences were compared.The scores and the rates of reduction of NIHSS in 24 h, 7d and 14 d after treatment of the two groups were analyzed, also the scores of 7dmRs and 90dmRS.The incidence of extracranial /intracranial hemorrhage, the rate of death was also compared between the two groups. Results There were no significant differences in baseline data and 24 hNIHSS score.NIHSS in 7 d and 14d after treatment were lower in intravenous thrombolysis group, p was 0.020 and 0.008 respectively.The rate of reduction of NIHSS in 24 h, 7d and 14 d were higher in intravenous thrombolysis group, all the three p were 0.000.The scores of 7 d and 90dmRS were lower in intravenous thrombolysis group, but only 7dmRS score between the two groups was statistically significant, P=0.014, while 90dmRS score between the two groups was not statistically significant, P=0.153.Both at 7 d and 90 d, the proportions of good prognosis(mRS score 0-2)inintravenous thrombolysis group were higher, but there was no differencebetween the two groups , neither at 7 d nor at 90 d after treatment, p were 0.109 and 0.358 respectively.The incidences of extracranial hemorrhage and intracranial hemorrhagewere higher in intravenous thrombolysis group, p was 0.000 and 0.018 respectively.But no symptomatic intracranial hemorrhageand death occurred in both groups. Conclusion Thrombolysis with rt-PA inmildacuteischemicstroke(NIHSS≤3) can improve early neurological deficits, increase the incidence of mild extracranial /intracranial hemorrhage, but with no serious adverse outcome.

Key words: MildIschemicStroke, Intravenousthrombolysis, Recombinant tissue plasminogen activator