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目的 探讨阿替普酶静脉溶栓治疗急性缺血性脑卒中(acute ischemic stroke,AIS)的临床效果及安全性.方法 选择中国人民武装警察部队总医院2015年2月-2016年12月诊治的AIS患者49例作为溶栓治疗组,同时选取同时期收治的20例非溶栓治疗的患者为对照组.采用美国国立卫生研究院卒中量表(NIHSS)对患者溶栓前及溶栓后24h、7d、14d进行评分并对可能出现的不良反应进行记录;溶栓90 d后采用改良Rankin量表(modified Rankin scale,mRS)对患者综合生活能力评估.结果 治疗开始后2组NIHSS评分均有下降,溶栓组在不同时间点NIHSS评分均低于对照组,差异有统计学意义(P<0.05).治疗90 d后mRS评分溶栓组明显低于对照组,差异有统计学意义(P<0.05).溶栓组与对照组相比脑出血及其他出血并发症的发生率增高,但对照组90 d死亡率明显高于溶栓组,差异有统计学意义.结论 对于发病时间在6 h内的AIS患者应用阿替普酶溶栓仍能取得良好的临床收益,改善预后,提高生活质量.“,”Objective To observe the explore the clinical efficacy and safety of alteplase in the treatment of acute ischemic stroke. Methods The 49 cases of AIS treated in our hospital from February 2015 to December 2016 were treated as thrombolytic therapy group,and 20 patients treated with non-thrombolytic therapy during the same period were treated as control group.The national institutes of health stroke scale(NIHSS)was used to grade the thrombolysis and thrombolysis of the patients before thrombolysis and thrombolysis, and to record the possible adverse reactions. The modified Rankin scale(mRS)was used to assess the comprehensive life ability of patients after 90 days.Results The NIHSS scores were decreased in both groups after the treatment began,and the NIHSS scores were lower than the control group at different time nodes, and the difference was statistically significant (P< 0.05). After 90 days, mRS score thrombolytic group was significantly lower than the control group,and the difference was statistically significant (P<0.05).The incidence of cerebral hemorrhage and other bleeding complications in thrombolytic group was higher than that in the control group, but the mortality rate in the control group was significantly higher than that in the thrombolytic group,and the difference was statistically significant.Conclusions For AIS patients with the onset time of 6h,the application of alteplase thrombolytic can still achieve good clinical benefit,improve the prognosis and improve the quality of life.