The mean age of the treated patient

The mean age of the treated patients was 64.1 ± 16.4 years; seven were men. The clinical characteristics of the patients are presented in Table 1. Initial NIHSS scores ranged from 10 to 26. The interval from onset of symptoms to treatment ranged from 2 to 9 hours. Occlusion sites were located in the cervical ICA (n=4), intracranial ICA (n=4), middle cerebral artery(MCA) (n=6), and vertebrobasilar artery (n=2).
Figure 1 demonstrates the effect of incremental doses of reteplase on perfusion represented by the modified TIMI scale. The mean perfusion grade before treatment (0.1 ± 0.5) improved with increasing doses of reteplase to 2.7 ± 1.1 with4 U and 3.1 ± 0.8 with 8 U. All patients except three received8 U of reteplase; complete recanalization was achieved in two patients before reaching maximum dose, and angiographically visible extravasation of contrast medium in one patient necessitated termination of the procedure. After completion of the infusion, six patients experienced complete restoration of blood flow (modified TIMI 4), eight patients experienced near-complete restoration of flow (modified TIMI 3), one patient experienced partial restoration of flow (modified TIMI2), and one patient experienced a minimal response (modified TIMI 1). In Figure 2, an example of angiographic response to increasing doses of reteplase is shown. With increasing doses of reteplase, the mean thrombus grade decreased from a pretreatment score of 3.9 ± 0.3 to 1.6 ± 1.8 with 4 U and 0.66 1.4 with 8 U (Fig. 3). Neurological improvement at 24 hours(defined as a decline in NIHSS score of $4) was observed in seven patients. Two patients experienced further improvement in NIHSS score at 7 to 10 days. Adjunctive angioplasty of the occluded artery was performed in seven patients. Four patients underwent angioplasty after 8 U of reteplase was administered. Three other patients underwent angioplasty after administration of 4, 5, and ± U of reteplase, respectively. Intraparenchymal hemorrhages were observed in four patients. Two patients experienced localized hematomas with mass effect but no midline shift, and two others experienced localized hematomas with mass effect and midline shift (Fig.4). Neurological worsening (one-point increase in NIHSS score) at 24 hours was observed in one of these patients. The overall mortality during hospitalization was 56% (9 of 16patients). The causes of death included massive ischemic stroke (n=7), withdrawal of care at the family’s request after the development of aspiration pneumonia and renal failure (n5 1), and a combination of intracerebral hemorrhage and massive ischemic stroke (n=1). Only one death was attributable to complications of intra-arterial thrombolysis (Patient5; Table 1).
DISCUSSION

結果 (中文) 1:

治疗的患者的平均年龄是 64.1 ± 16.4 年;7 名男子。表 1 介绍了病人的临床特点。最初用 NIHSS 评分介乎 10 至 26。从出现症状到治疗从 2 到 9 小时间隔。闭塞站点位于宫颈 ICA (n = 4)，颅内 ICA (n = 4)，中间大脑中 (n = 6)，和椎基底动脉 (n = 2)。图 1 演示了增量剂量的瑞替普酶对灌注由改性 TIMI 规模的影响。平均灌注年级之前治疗 (0.1 ± 0.5) 随提高剂量的瑞替普酶对 2.7 ± 1.1 with4 你和 3.1 ± 0.8 8 美国与所有患者都除三 received8 U 的瑞替普酶;在到达最大剂量前, 两个病人取得了完全再通，造影可见外的渗造影剂在一个病人需要的过程终止。完成后的输液、 六名病人经验丰富完整恢复血流 (改性 TIMI 4) 和八个病人经验丰富附近完成恢复的流 (改性 TIMI 3)，一个病人经历部分恢复了流 (改性 TIMI2)，和一个病人经历最小响应 (改性 TIMI 1)。在图 2 中显示了一个示例的血管造影响应增加剂量的瑞替普酶。随着剂量的瑞替普酶，平均血栓等级下降 3.9 ± 0.3 至 1.6 ± 1.8 4 与预处理得分从你和 0.66 1.4 8 U (图 3)。7 例患者出现神经功能改善在 24 小时内 (定义为 4 美元的 NIHSS 评分下降)。两个病人经历进一步改善 NIHSS 评分在 7 至 10 天。七名病人进行辅助动脉成形术闭塞。四名病人血管成形术后 8 U 的瑞替普酶管理。分别三个其他患者的 4、 5 和 ± U 的瑞替普酶，给药后血管成形术。脑实质出血观察四名患者。质量效应的两个病人有经验局部的血肿，但没有中线结构移位，和另外两个经历了局部的血肿占位效应与中线移位 (图 4)。神经功能恶化 (单点增加 NIHSS 评分) 在 24 小时有人在其中一个病人。住院期间整体死亡率为 56%(9 16patients)。死亡的原因包括严重的缺血性中风 (n = 7)，撤出的照顾家庭的请求后吸入性肺炎和肾功能衰竭的发展 (n5 1)，和脑出血和严重的缺血性中风的组合 (n = 1)。只有一人死亡是由于致并发症的动脉内溶栓 (Patient5;表 1)。讨论

結果 (中文) 3:

患者平均年龄为64.1岁，16.4岁，男性七岁。患者临床特点见表1。初始NIHSS评分范围从10到26。从症状到治疗的时间间隔从2到9个小时不等。阻塞部位位于颈部的ICA（n = 4），ICA颅内（n = 4），大脑中动脉（MCA）（n = 6），和椎-基底动脉（n = 2）。图1显示了
瑞替普酶改良的TIMI规模增量表示灌注剂量的影响。治疗前平均灌注分级（0.1±0.5）改进的剂量增加到2.7±瑞替普酶1.1 4 U和3.1±0.8美国8所有患者除三received8 U瑞替普酶；完全再通了两例在达到最大剂量，并在一个病人造影剂造影可见渗出需要终止的程序。完成后的输液，六例血流完全恢复（改良的TIMI 4），八例患者有近流完全恢复（改良的TIMI 3），一个病人经历过流部分恢复（修改timi2），和一个病人经历了一个最小的响应（改良的TIMI 1）。在图2中，以增加剂量瑞替普酶造影反应的一个例子示出。随着剂量瑞替普酶，平均品位降低血栓从3.9 0.3到1.6 1.8±±4 U和0.66 1.4 8 U处理评分（图3）。神经功能改善24小时（定义为一个4美元的NIHSS评分下降）观察七例。两患者NIHSS评分在7至10天的进一步改进。辅助血管成形术闭塞动脉进行七例。四例患者给予瑞替普酶U 8行血管成形术。其他三例4，5局后接受血管成形术，并±U瑞替普酶，分别。脑实质内出血四例。两例患者出现局部血肿与质量效应而无中线移位，两人经历了局部血肿与质量效应和中线移位（图）。神经功能恶化（NIHSS评分增加一点）在24小时在这些患者中观察到。住院期间死亡率为56%（9例）。死亡原因包括大量的缺血性卒中患者（n = 7），停止治疗在家庭的要求开发后吸入性肺炎和肾功能衰竭（N5 1），脑出血与大面积缺血性脑卒中（1例）的结合。只有一人死亡是由于动脉溶栓并发症（病人；表1）。
讨论