[目的]观察经磁共振弥散加权成像(DWI)和灌注加权成像(PWI)检查判定其不匹配≥20%为标准指导下急性脑梗死的溶栓治疗情况,评价其安全性及有效性.[方法]对24例DWI/PWI不匹配≥20%的急性脑梗死患者进行溶栓治疗,治疗14d后予复查DWI、PWI,比较治疗前后弥散和灌注参数值以及神经功能评分(NIHSS评分)的变化,观察颅内出血等并发症的发生情况.[结果]治疗14 d后患者弥散和灌注参数较治疗前改善明显(P<0.01),NIHSS评分亦有明显改善(P<0.05),经临床观察以及头颅CT证实未发现颅内出血.[结论]以DWI/PWI不匹配≥20%为标准指导急性脑梗死溶栓治疗安全、有效.%[Objective]To observe the thrombolytic therapy of acute cerebral infarction under the guidance of the standard of diffuse weighing imaging(DWI) and perfusion weighted imaging(PWI) mismatch ≥20%, and evaluate its safety and effectiveness. [Methods]A total of 24 cases of acute cerebral infarction with DWI/ PWI mismatch ≥ 20% received thrombolytic therapy. DWI and PWI were reexamined 14d after treatment. The changes of diffuse and perfusion parameters and neurological function score(NIHSS score) were compared between before and after treatment. The incidence of the complications such as intracranial hemorrhage was observed. [Results]Compared with before treatment, the diffuse and perfusion parameters were obviously im-proved(P <0. 01), and NIHSS score was also improved 14d after treatment( P <0. 05). No intracranial hemorrhage was found confirmed by clinical observation and CT scan. [Conclusion]Thrombolytic therapy of a-cute cerebral infarction guided by the standard of mismatch ≥20% in DWI/PWI is safe and effective.
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