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[摘要] 目的 探討静脉溶栓治疗轻型脑卒中患者的有效性和安全性。 方法 回顾性分析2017年12月至2019年12月收治于我院的发病4.5 h内、美国国立卫生研究院卒中量表（NIHSS）评分≤5分的轻型缺血性脑卒中患者95例，其中溶栓组45例，未溶栓组50例。比较两组患者基线资料、ΔNIHSS（入院NIHSS评分-出院NIHSS评分）、出院时改良Rankin′s量表评分（mRS）、90 d随访时mRS评分判断预后，同时比较两组治疗相关并发症发生率，并分析其安全性。 结果 两组患者基线资料比较，差异无统计学意义（P>0.05）。溶栓组患者ΔNIHSS高于未溶栓组，差异有统计学意义（P<0.05）;溶栓组患者出院时mRS评分0～2分者多于未溶栓组，差异有统计学意义（P<0.05）;溶栓组患者90 d mRS评分0～2分者多于未溶栓组，但差异无统计学意义（P>0.05）。溶栓组患者发生治疗相关并发症4例，均为溶栓过程中牙龈出血，发生率为8.89%;未溶栓组患者均未发生治疗相关出血并发症，发生率为0.00%，组间比较差异有统计学意义（P<0.05），两组患者均未出现颅内出血、消化道出血等严重并发症。溶栓组死亡率为2.22%，未溶栓组死亡率为2.00%，两组患者死亡率比较，差异无统计学意义（P>0.05）。 结论 阿替普酶静脉溶栓治疗轻型脑卒中患者是可以获益的，并不增加颅内出血等严重不良事件的发生率及死亡率，安全性好。
[关键词] 轻型脑卒中;静脉溶栓;阿替普酶;安全性
[Abstract] Objective To explore the efficacy and safety of intravenous thrombolysis with alteplase in the treatment of patients with mild stroke. Methods Ninety-five mild ischemia with a score of ≤5 on the National Institutes of Health Stroke Scale（NIHSS） within 4.5 hours of onset in our hospital from December 2017 to December 2019 were retrospectively analyzed， including 45 in the thrombolysis group and 50 in the non-thrombolysis group. Baseline data， ΔNIHSS （admission NIHSS score-discharge NIHSS score）， modified Rankin′s scale score（mRS） at discharge， mRS score at 90 days follow-up were used to judge the prognosis. The treatment-related complications occurred between the two groups were compared. Its safety was analyzed. Results There was no significant difference in baseline data between the two groups. The ΔNIHSS（admission NIHSS score-discharge NIHSS score） of the thrombolysis group was higher than that of the non-thrombolysis group， and the difference was statistically significant（P
[关键词] 轻型脑卒中;静脉溶栓;阿替普酶;安全性
[Abstract] Objective To explore the efficacy and safety of intravenous thrombolysis with alteplase in the treatment of patients with mild stroke. Methods Ninety-five mild ischemia with a score of ≤5 on the National Institutes of Health Stroke Scale（NIHSS） within 4.5 hours of onset in our hospital from December 2017 to December 2019 were retrospectively analyzed， including 45 in the thrombolysis group and 50 in the non-thrombolysis group. Baseline data， ΔNIHSS （admission NIHSS score-discharge NIHSS score）， modified Rankin′s scale score（mRS） at discharge， mRS score at 90 days follow-up were used to judge the prognosis. The treatment-related complications occurred between the two groups were compared. Its safety was analyzed. Results There was no significant difference in baseline data between the two groups. The ΔNIHSS（admission NIHSS score-discharge NIHSS score） of the thrombolysis group was higher than that of the non-thrombolysis group， and the difference was statistically significant（P