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目的旨在探讨静脉溶栓治疗急性缺血性脑卒中的最佳治疗时间窗。方法采用静脉输注尿激酶进行前瞻性随机对照的临床试验。按发病距治疗的时间将入选的２５例病人分为治疗组（发病距治疗时间＜４小时）和对照组（发病距治疗时间４～１２小时）。以欧洲脑卒中神经功能缺损计分（ＴｈｅＥｕｒｏｐｅａｎＳｔｒｏｋｅＳｃａｌｅ）为标准，对照比较两组病人的起效时间、总体疗效、疗后转归及安全范围。结果治疗组起效时间（１５～１８０分钟）较对照组（２．３～２８小时）显著缩短。疗后一个月神经功能缺损计分，治疗组较对照组有显著的改善（Ｐ＜０．０５）。对照组溶栓后发生皮下和齿龈出血２例。治疗组无１例并发症发生。结论静脉溶栓治疗急性缺血性脑卒中是早期开通闭塞脑血管的有效和理想的方法。最佳的治疗时机（时间窗）应当选择在发病后的４小时以内。
The purpose of this study was to explore the optimal treatment time window for intravenous thrombolytic therapy for acute ischemic stroke. Methods A prospective, randomized, controlled clinical trial of intravenous infusion of urokinase was performed. According to the time from the onset of treatment will be selected 25 cases were divided into treatment group (incidence of treatment time <4 hours) and control group (onset from the treatment time of 4 to 12 hours). The European stroke neurological deficit score (TheEuropeanStrokeScale) as a standard, comparison of the two groups of patients onset time, the overall effect, outcome after treatment and safety range. Results The onset time of the treatment group (15 ~ 180 minutes) was significantly shorter than that of the control group (2.3 ~ 28 hours). One month after treatment, neurological deficit score was significantly improved in the treatment group compared with the control group (P <0.05). Two cases of subcutaneous and gingival bleeding occurred in the control group after thrombolysis. No complications occurred in the treatment group. Conclusion Intravenous thrombolysis in acute ischemic stroke is an effective and ideal method for early occlusion of cerebrovascular. The best timing of treatment (time window) should be selected within 4 hours after onset.