中文摘要：

目的评价在溶栓时间窗内,对伴未破裂颅内动脉瘤（UIAs）的急性脑梗死（ACI）患者行静脉溶栓治疗的安全性。方法选取2010年1月—2015年12月在石河子大学医学院第一附属医院神经内科卒中单元接受静脉溶栓治疗的ACI患者245例,均接受重组组织型纤溶酶原激活剂阿替普酶（rt-PA）静脉溶栓治疗。溶栓后36 h内复查颅脑CT,36 h-7 d完成颅内血管评估。根据血管评估结果,将纳入患者分为无UIAs组（n=224）和UIAs组（n=21）。记录并比较两组患者溶栓前和溶栓7 d后的美国国立卫生研究院卒中量表（NIHSS）评分、溶栓90 d后的改良Rankin量表（mRS）分级,以及溶栓后的出血情况。结果共检出伴UIAs患者21例（8.6%）,UIAs 25个,直径为2.0-8.0 mm,平均直径为（4.1±1.7）mm。两组患者性别、平均年龄、吸烟率、饮酒率、合并糖尿病发生率、合并高血压发生率、合并高脂血症发生率、合并心房颤动发生率、发病至溶栓时间,溶栓前BMI、收缩压、舒张压,溶栓次日空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、血小板计数、尿酸比较,差异均无统计学意义（P〉0.05）;UIAs组患者溶栓次日低密度脂蛋白（LDL）、同型半胱氨酸低于无UIAs组,差异有统计学意义（P〈0.05）。溶栓前和溶栓7 d后,两组患者NIHSS评分比较,差异均无统计学意义（P〉0.05）;溶栓7 d后两组患者NIHSS评分均低于溶栓前,差异有统计学意义（P〈0.05）。溶栓90 d后,两组患者mRS为0-2级发生率比较,差异无统计学意义（P〉0.05）。两组患者溶栓后非症状性颅内出血（N-sICH）、症状性颅内出血（sICH）、蛛网膜下腔出血（SHA）发生率比较,差异均无统计学意义（P〉0.05）。结论对伴≤8.0 mm UIAs的ACI患者行静脉溶栓治疗可能不会增加患者的动脉瘤破裂出血风险,这为静脉溶栓患者的选择和判断提供了依据,但结果?

英文摘要：

Objective To evaluate the safety of intravenous thrombolytic therapy in patients with acute cerebral infarction（ ACI） combined with unruptured intracranial aneurysms（ UIAs） in the thrombolysis time window.Methods A total of 245 patients with ACI who received intravenous thrombolysis therapy in the Stroke Unit of Department of Neurology of the First Affiliated Hospital of the Medical College,Shihezi University from January 2010 to December 2015 were enrolled.All subjects received intravenous thrombolytic therapy of recombinant tissue-type plasminogen activator alteplase（ rt-PA）.After thrombolysis,patients were reexamined with brain CT scan within 36 hours,and intracranial vascular assessment was completed between 36 hours and 7 days.All patients were divided into group without UIAs（ n = 224） and group with UIAs（ n = 21）according to their vascular assessment results.The National Institute of Health Stroke Scale（ NIHSS） score of patients in two groups before thrombolysis and seven-day after thrombolysis,their modified Rankin Scale（ mRS） grading after 90-day thrombolysis and bleeding condition after thrombolysis were recorded and compared.Results A total of 21 patients combined with UIAs（ 8.6%） were detected,and 25 UIAs,a diameter between 2.0 to 8.0 mm and an average diameter of（ 4.1 ± 1.7）mm.There was no significant difference in gender,average age,smoking proportion,drinking proportion,and proportion of combining with diabetes,hypertension,hyperlipemia and atrial fibrillation,time from onset to thrombolysis,and BMI,systolic blood pressure and diastolic blood pressure before intravenous thrombolysis,the fasting blood glucose（ FPG）,glycosylated hemoglobin（ HbA1c）,total cholesterol（ TC）,triglyceride（ TG）,platelet count and serum uric acid in the day after thrombolysis of patients between two groups（ P〉0.05）; the levels of low density lipoprotein（ LDL） and homocysteine in the day after thrombolysis in group with UIAs were significantly lower than those in g