关键词: 急性脑梗死, 经颅多普勒, 静脉溶栓, 微栓子, 预后

Abstract: This study investigated the clinical value of transcranial Doppler (TCD) in patients with acute cerebral infarction (ACI) to observe the changes of microemboli after intravenous thrombolysis. Selected 134 ACI patients treated with intravenous thrombolytic therapy with alteplase (rt-PA), and all the patients were monitored by TCD. They were divided into micro thrombus group (micro thrombus formation) with 55 cases and control group (no micro thrombus formation) with 79 cases. Compared the relationship of National Institutes of Health Stroke Scale (NIHSS) score, carotid plaque characteristics, and infarct size at different time points before and after thrombolytic therapy between the two groups. All patients were followed up for 3 months to observe and evaluate the prognosis, and to analyze the relationship between the microemboli formation and the recovery effect of patients. The NIHSS scores of the micro thrombus group at 7 days and 14 days of thrombolysis treatment were higher than those of the control group (P<0.05). The proportion of patients with large-area infarction was higher than that of the control group (P<0.05). Multivariate analysis showed that increased NIHSS score on admission, patients with coronary heart disease, large infarction lesions, and microembolism after thrombolysis were independent risk factors for poor prognosis in patients with ACI treated with rt-PA intravenous thrombolysis (P<0.05). Intravenous thrombolysis with rt-PA in ACI patients complicated with microembolism will adversely affect the prognosis and recovery of patients.

Key words: acute cerebral infarction, transcranial Doppler, intravenous thrombolysis, microemboli, prognosis