目的　评价动脉内尿激酶溶栓治疗急性脑梗死的结果 ,并明确影响预后的因素。方法　对4 8例急性颅内动脉闭塞患者在发病 6h内进行了局部动脉内尿激酶灌注治疗。结果　 4 8例患者中有 17例(35 % )获得完全再通 ,其中 13例椎基底动脉阻塞者有 8例 (6 2 % ) ,2 0例大脑中动脉阻塞者有 9例(45 % ) ,而 15例颈内动脉阻塞者则无一例完全再通。 6 0 %大脑中动脉阻塞者神经状态得到改善 ,而椎基底动脉与颈内动脉阻塞者分别有 39%与 2 0 %得到改善 (P <0 0 5 )。总的死亡率为 2 1%。结论　大脑中动脉阻塞的患者血管完全再通后神经状态可得到改善 ,而椎基底动脉阻塞者再通与临床改善两者间并无必然联系 ,颈内动脉阻塞者则很难获得完全再通 Objective To evaluate the results of intra-arterial urokinase thrombolysis in the treatment of acute cerebral infarction and to clarify the factors affecting the prognosis. Methods Forty-eight patients with acute intracranial arterial occlusion were treated with intra-arterial instillation of urokinase within 6 hours of onset. RESULTS: Thirty-seven (35%) of 48 patients were completely recanalized, including 13 (62%) in 13 cases of vertebrobasilar artery obstruction and 9 (45%) in 20 cases of middle cerebral artery occlusion , While 15 cases of internal carotid artery occlusion were not completely recanalized. Neurological status was improved in 60% of middle cerebral artery occlusion patients, while those in vertebrobasilar artery and internal carotid artery occlusion improved by 39% and 20%, respectively (P <0.05). The overall mortality rate was 21%. Conclusion The neurological status of the patients with occlusion of the middle cerebral artery may be improved after the complete recanalization of blood vessels. There is no necessary connection between the recanalization of vertebrobasilar artery obstruction and clinical improvement, and it is very difficult for the occlusion of the internal carotid artery to obtain complete recanalization