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目的观察重组组织型纤溶酶原激活物(rt-PA)溶栓治疗合并脑心综合征的急性脑梗死的疗效。方法合并脑心综合征急性脑梗死患者102例,将其分为观察组47例、对照组55例。对照组给予常规皮下注射低分子肝素抗凝及口服阿司匹林抗血小板聚集治疗;观察组采用rt-PA溶栓治疗,24 h后口服阿司匹林、氯吡格雷。分别于两组治疗前及治疗后72 h行心电图检查、NIHSS评分,检测血浆N末端B型脑钠肽前体(NT-pro BNP)及血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(TnI)和S100B蛋白。结果观察组治疗后72 h有36例(76.6%)患者心电图检查转为正常,34例(72.3%)NT-pro BNP转为正常;对照组分别为9例(16.4%)、0例(0)。两组相比,P均<0.01。两组治疗后,NIHSS评分、血清S100B蛋白均较治疗前明显降低,且观察组低于对照组(P均<0.05)。观察组治疗72 h血清CK-MB、TnI及血浆NT-pro BNP水平较治疗前降低(P均<0.01),且均低于对照组(P均<0.05)。结论 rt-PA溶栓治疗合并脑心综合征的急性脑梗死可减轻患者脑组织及心肌损伤,改善神经功能。 [ABSTRACT FROM AUTHOR]