目的：急性缺血性脑卒中疾病的治疗中应用阿替普酶静脉溶栓方案联合神经介入疗法的效果探讨。方法：讨论样本为罹患急性缺血性脑卒中疾病的患者，共60例，选择时间即2019年1月-2022年1月，依据系统抽样法将纳入样本均分成讨论及参照两组，前者采取阿替普酶静脉溶栓联合神经介入疗法，后者仅使用阿替普酶静脉溶栓方案，比较组间神经功能缺损评分、生活自理能力评分、炎症因子水平、临床疗效及并发症情况。结果：3个月治疗完成后，讨论组的神经功能缺损评分明显下降，生活自理能力评分升高，炎症因子水平降低，临床疗效显著，且并发症总发

目的 观察阿加曲班联合神经节苷脂治疗急性脑卒中的疗效,并分析其作用机制,为临床提供参考.方法 选取2019年2月至2022年2月南京市浦口区中心医院收治的80例急性脑卒中患者为研究对象进行回顾性分析.根据治疗方法的不同将患者分为观察组(42例,行阿加曲班联合神经节苷脂治疗)和对照组(38例,行替罗非班联合神经节苷脂治疗).比较两组患者的治疗效果,记录预后和不良反应发生情况.分别在治疗前后检测两组患者炎症因子和凝血功能指标水平,比较血清髓鞘碱性蛋白(MBP)和心型脂肪酸结合蛋白(H-FABP)水平.结果 观察组患者总有效率显著高于对照组(P<0.05);两组患者不良反应发生率及不良预后发生率比较,差异无统计学意义(P>0.05);治疗后两组患者白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平均低于治疗前,且观察组低于对照组(P<0.05);治疗后两组患者血浆D-二聚体(D-D)水平显著低于治疗前,凝血酶时间(TT)和国际标准化比值(INR)水平显著高于治疗前(P<0.05);治疗后观察组患者血浆D-D水平显著低于对照组,TT和INR水平显著高于对照组(P<0.05);治疗后两组患者血清MBP和H-FABP水平显著低于治疗前,且观察组低于对照组(P<0.05).结论 阿加曲班联合神经节苷脂治疗急性脑卒中效果显著,有助于保护神经功能,其机制与阿加曲班具有良好的抗凝、抗炎作用有关.

Objective To investigate the properties and remodeling pattern of basilar artery atherosclerosis in paramedian pontine infarction(PPI) with 3.0T high-resolution magnetic resonance imaging(HRMRI). Methods Thirty consecutive patients with acute paramedian pontine infarction were enrolled from January 2011 to December 2012, all are detected by conventional magnetic resonance imaging(MRI) and magnetic resonance angiography(MRA), and HRMRI was performed on the target segment by using a 3.0T MR scanner. Remodeling index(RI) was calculated as vessel area at maximal lumen narrowing(MLN)/reference vessel area. RI≤0.95 was defined as negative remodeling(NR), 0.95<RI<1.05 as intermediate remodeling(IR), and RI≥1.05 as positive remodeling(PR), wall characteristics were compared between the NR and PR group. Results In 30 patients, 9 arteries were shown stenosis, 21 arteries were shown normal on MRA, while HRMRI detected 25 arteries with plaque, and the basilar artery(BA) plaques at or near the origin of the penetrating artery. Analyze the 25 patients, NR was found in 8 patients, IR in 6 patients, and PR in 11 patients. At MLN sites, compared with lesions with NR, lesions with PR had greater plaque area([8.17±4.7]mm2vs [1.08±1.89]mm2, P<0.01), and a greater percent plaque burden([29.07±15.03]% vs [3.96±6.76]%, P<0.01). Conclusion HRMRI can help assess subtypes of ischemic stroke and the remodeling pattern of BAatherosclerosis. Etiology of PPI is the BA plaque blocking the penetrating artery. In patients with PPI, NR and PR lesions are some frequently observed, and PR lesions have a greater wall area and plaque burden than NR lesions.

Objective To study the value of susceptibility weighted imaging(SWI)in etiological diagnosis of cerebral hemorrhage due to amyloid cerebral disease.Methods 128patients with head CT-confirmed cerebral hemorrhage admitted to our hospital from June 2011to December 2012,23underwent SWI scanning.Their hemorrhagic foci detected by head CT and SWI were compared.The patients were followed up for 4-18 months(mean 10.78±5.31 months)by telephone.Results Of the 23patients who underwent SWI scanningm,9(39.13%)met the Boston cerebrovascular disease diagnosis criteria.Head CT showed 10hemorrhagic foci but no cerebral microbleeding(CMB).Ninety-five CMB were detected by SWI,which were much more than those detected by head CT.The condition of the patients was stable except 1who lost the follow-up,1who died of recurrent cerebral hemorrhage,and 1whose condition was excerbated.Conclusion The sensitivity of SWI is significantly higher than that of head CT in detecting CMB,thus contributing to the early diagnosis of cerebral hemorrhage due to amyloid cerebral disease.