Objective To discuss the relationship between emergency biochemical indicators before intravenous thrombolysis and the early clinical improvement and prognosis after intravenous thrombolysis of acute ischemic stroke. Methods From June 2014 to May 2019,67 patients with acute ischemic stroke were treated by intravenous thrombolysis with ateplase in Beijing Jishuitan Hospital. The NIHSS score before thrombolysis and 24 hours after thrombolysis were re-corded,and the early clinical improvement was assessed by the difference between them(ΔNIHSS). ΔNIHSS≥4 was di-vided into excellent group,1-3 into effective group and ≤0 into ineffective group. Early prognosis was recorded by Modi-fied Rankin score(mRS)on 7 days after thrombolysis:mRS score(≤2)was divided into good prognosis group and 3-4 into general prognosis group and 5-6 into poor prognosis group. To compare the differences of biochemical indicators before thrombolysis among the above groups. The measurement data were expressed as mean ± standard deviation(χ ± SD). Inde-pendent sample t test was used to compare the two samples. Results 1. Compare the emergency biochemical indicators be-tween the excellent group(n=10)and the ineffective group(n=30)at 24hours after thrombolysis,the indicators which have significant difference include:T-Bil(14. 28 ± 4. 77 mmol/L VS 11. 22 ± 3. 86 mmol/L,P=0. 048),blood glucose(6. 82 ± 1. 18 mmol/L VS 8. 99 ± 4. 31 mmol/L,P=0. 017). Compare the emergency biochemical indicators between the effective group(n=10)and the ineffective group(n=30)after thrombolysis 24hours,the indicators which have significant difference include:T-Bil(14. 89 ± 5. 88 mmol/L VS 11. 22 ± 3. 86 mmol/L,P=0. 007),D-Bil(4. 63 ± 1. 89mmol/L VS 3. 62 ± 1. 22mmol/L,P=0. 019),blood glucose(6. 86 ± 1. 50 mmol/L VS 8. 99 ± 4. 31 mmol/L,P=0. 016). 2. Compare the three different prognosis group at 7 days after thrombolysis. There was significant difference in uric acid level before throm-bolysis between the good prognosis group(n=56)and the poor prognosis group(n=9)(397 ± 96. 62 mmol/L VS 344. 33 ± 59. 46 mmol/L,P=0. 041). Conclusion Higher level of bilirubin and lower level of blood glucose before thrombolysis were correlated with the better early clinical improvement at 24 hours after thrombolysis,while higher level of uric acid be-fore thrombolysis were correlated with better prognosis at 7 days after thrombolysis.

目的 分析肢体抖动型短暂性脑缺血发作(limb-shaking transient ischemic attack,LS-TIA)的临床及血管病变特点.方法 采用回顾性分析方法,收集我院2011年1月～ 2013年10月间以发作性肢体抖动为临床表现的TIA患者,收集患者的临床资料及治疗方案,记录临床和影像学随访结果,记录随访期间有无脑血管事件发生.结果 共收集肢体抖动型TIA患者5例,均存在抖动肢体对侧的颅内外大动脉重度狭窄或闭塞,除1例烟雾病患者,其余4例均接受抗血小板、强化他汀治疗,其中2例接受颈内动脉支架植入术治疗.发病后6个月复查头部MRI均未见新发梗死灶,临床随访6～33个月,均无脑血管事件发生.结论 单侧肢体抖动是TIA的一种发作形式,多存在对侧的颅内外大动脉重度狭窄或闭塞,血管重建治疗及规范的药物治疗对减少脑血管事件可能均有效.