Objective To evaluate the efficacy and safety of Actilyse ( recombinant tissue plasminogen activator, rt PA ) in early treatme.nt of patients with acute cerebral infarctions.Methods Sixty - four qualified patients were randomly divided into the observation group and the control group.The observation group were treated with rt - PA ( 0.9 mg/kg ) ( no more than 90 mg ).Firstly, intravenous injection was performed hy which 10％ of the drug was administered within 1 minute ; then the remaining 90％ was injected continuously in 60 minutes.The control group was treated with aspirin ( 300 mg/d ).The Chinese Stroke Scale ( CSS ) and the Barthel Index ( BI ) were used to evaluate the neurological functions before and 90 days after treatment.Results CSS scores and BI of the observation group and the control group showed no significant difference before treatment ( P ＞0.05 ) and were significantly different after treatment ( P ＜0.01 ).In the observation group, recovery was seen in 13 cases, the treatment was found to be remarkably effective in 11 cases.effective in 6 cases, and no changes were observed in the left 2 cases; in the control group, 8 cases recovered, the treatment was found to be remarkably effective in 9 cases, effective in 11 cases, and no changes were ohserved in the other 4 cases; efficacy between the two groups was significantly different ( u =2.34, P ＜0.05 ).Conclusion Intravenous rt - PA thrombolysis in patients with acute cerebral infarctions within 6 hours from onset is both effective and safe.and the efficacy is superior to that of the control group.%目的 评价重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死的疗效及安全性.方法 将符合入选标准的64例患者随机分为观察组和对照组,观察组采用rt-PA 0.9 mg/kg(最大剂量90 mg)治疗,先静脉注射10%(1 min),其余剂量连续静脉滴注,60 min滴完;对照组采用拜阿司匹林300 mg;分别于溶栓前及溶栓后90 d,采用中国脑卒中临床神经功能缺损评分量表(CSS)及Barthel指数(BI)对患者进行评定,对比两组的疗效.结果 治疗前观察组的CSS评分和BI与对照组比较差异均无统计学意义(P＞0.05),而治疗后两组的CSS评分、BI间差异均有统计学意义(P＜0.01);观察组基本痊愈13例,显著有效11例,有效6例,无变化2例;对照组基本痊愈8例,显著有效9例,有效11例,无变化4例,两组疗效间差异有统计学意义(u=2.34,P＜0.05).结论 发病6 h内采用rt-PA静脉溶栓治疗急性脑梗死的疗效优于对照组.rt-PA 6 h内静脉溶栓治疗急性脑梗死是安全有效的.
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