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【目的】探讨重组组织型纤溶酶原激活剂（rt‐PA ）溶栓治疗急性脑梗死的近期疗效及影响因素。【方法】回顾性分析中国医科大学附属第四医院神经内科自2012年9月至2014年9月收治的81例急性脑梗死应用rt‐PA溶栓治疗的患者，入院及发病24 h进行美国国立卫生研究院卒中量表（NIHSS ）评分，将评分的差值作为患者结局变量，分为预后良好组（NIHSS差值≥4分或≥50％）及预后不良组（NIHSS差值＜4分或＜50％）。选取溶栓前临床及实验室资料，筛选与不良预后相关的可能因素，进行单因素及多因素分析。【结果】溶栓治疗后预后良好组42例（51．9％），预后不良组39例（48．1％），统计学分析结果显示影响溶栓疗效的因素为溶栓时间窗、血糖、NIHSS评分。【结论】静脉溶栓的近期疗效有明确的时间依赖性。血糖、NIH‐SS评分为早期预后的影响因素。“,”[Objective] To explore the short‐term efficacies and influencing factors of recombinant tissue plasminogen activator (rt‐PA) for acute cerebral infarction .[Methods] The clinical data were analyzed retro‐spectively for 81 patients with acute cerebral infarction on rt‐PA thrombolytic therapy from September 2012 to September 2014 at our department .The NIH stroke scale (NIHSS) scores were assessed at admission and 24 hours after thrombolysis .Then with score difference as outcome variables ,they were divided into good (NIH‐SS difference ≥4 points or ≥50% ) and poor (NIHSS difference <4 <50% ) prognosis groups .By selecting the pre‐thrombolysis clinical and laboratory data ,the possible factors associated with a poor prognosis were screened .And univariate and multivariate analyses were performed .[Results] Among them ,42 patients (51 .9% ) had a good prognosis and 39 (48 .1% ) a poor prognosis after thrombolysis .The results of statistical analysis showed that the influencing factors of thrombolytic efficacy included thrombolytic time window ,blood sugar and NIHSS score .[Conclusion] The short‐term efficacy of intravenous thrombolysis have a distinct time dependence .Blood glucose and NIHSS score are the influencing factors of early prognosis .