目的探討重組組織型纖溶酶原激活劑（rt-PA）靜脈溶栓治療急性腦梗死合并心房顫動患者的價值。方法采用前瞻性研究方法,選擇2015年2月-2016年8月在西電集團(tuán)醫(yī)院進(jìn)行診治的急性腦梗死患者74例,根據(jù)隨機(jī)信封抽簽原則分為觀察組與對照組各37例。對照組應(yīng)用尿激酶靜脈溶栓治療,觀察組應(yīng)用rt-PA靜脈溶栓治療,均治療7 d。觀察兩組臨床療效、mRS評分及治療后癥狀性腦出血與非癥狀性腦出血情況。結(jié)果觀察組與對照組的治療有效率分別為94.6%和75.7%,觀察組的治療有效率明顯高于對照組（P<0.05）。治療后觀察組與對照組的mRS評分分別為（5.22±1.83）分和（7.29±1.45）分,都明顯低于治療前的（10.24±1.31）分和（10.19±1.52）分（P<0.05）,且觀察組評分明顯低于對照組（P<0.05）。觀察組的癥狀性腦出血與非癥狀性腦出血分別為5.4%和2.7%,都明顯低于對照組的18.9%和16.2%（P<0.05）。結(jié)論 rt-PA靜脈溶栓治療急性腦梗死合并心房顫動患者是安全有效的,能促進(jìn)神經(jīng)功能的改善,有很好的應(yīng)用價值。

Objective To investigate the values of recombinant tissue type plasminogen activator (rt-PA)) in the treatment of acute cerebral infarction complicated with atrial fibrillation.Methods Used the prospective research methods,74 patients of acerebral infarction complicated with atrial fibrillation in Xi'an XD Group Hospital from February 2015 to August 2016 were selected and were equally divided into the observation group and the control group accorded to the principle of random envelope drawing.The control group was treated with urokinase intravenous thrombolytic therapy,the observation group was treated with rt-PA intravenous thrombolytic therapy,and the prognosis of the two groups were observed.Results There were no significant differences in gender,age,time window,disease,systolic blood pressure and diastolic blood pressure compared between the two groups.The treatment efficiency in the observation group and control group were 94.6% and 75.7%,the observation group was significantly higher than that of the control group (P < 0.05).After treatment,the mRS scores in the observation group and the control group were (5.22±1.83) points and (7.29±1.45) points,were significantly lower than those before treatment of (10.24±1.31) points and (10.19 ±1.52) points (P < 0.05),and the observation group was significantly lower than the control group (P < 0.05).In the observation group,the symptomatic intracerebral hemorrhage and non symptomatic cerebral hemorrhage were 5.4% and 2.7% respectively,so that were 18.9% and 16.2% in the control group that the observation group were significantly lower than those of the control group (P < 0.05).Conclusion Intravenous thrombolysis with recombinant tissue type plasminogen activator of patients with acute cerebral infarction combined with atrial fibrillation is safe and effective,it can promote the improvement of neurological function, and has good application value.