脑梗死急性期早期治疗诊治.pptVIP

脑梗死急性期的早期治疗措施 复旦大学附属华山医院 董 强 中国脑血管病论坛 ? 2003 超早期脑梗死的溶栓治疗 静脉溶栓治疗 tPA NINDS ECASS I II, ATLANTIS Streptokinase MAST-I, MAST-E, ASK 动脉溶栓治疗 前循环: MCA （PROACT II） 后循环: Basilar artery NINDS rt-PA 试验设计 Part 1 Part 2 Exclusion criteria Inclusion criteria Part 1 Randomization Part 2 Randomization rtPA (144) rtPA (168) Placebo (147) Placebo (165) Primary outcome: ≥4-point improvement on NIHSS or complete resolution at 24 hrs Primary outcome: global test statistic for favorable outcome (minimal or no disability at 3 months using 4 scales) NINDS rt-PA 试验：Part 1 Primary Outcome （24 hrs） NS % patient