目的：分析影响急性脑梗死患者静脉溶栓治疗效果的相关危险因素。方法：对收治的83例符合溶栓标准的急性脑梗死患者使用阿替普酶进行静脉溶栓，根据溶栓疗效分为溶栓成功组和溶栓未成功组，对两组的一般资料和颈动脉超声结果进行比较。结果：两组患者的发病年龄（65.8岁vs 74.6岁）、发病-溶栓时间窗（2.8 h vs 3.6 h）、糖尿病合并率（41.7% vs 66.1%）、颈动脉内膜-中膜厚度（IMT）均值（1.02 mm vs 1.28 mm）、颈动脉斑块数（1.32个vs 2.11个）差异均有统计学意义（P<0.05）；而高血压患病率、血脂水平、血纤维蛋白原（Fbg）水平差异均无统计学意义（P>0.05）。Logistic回归分析显示，发病年龄、发病-溶栓时间窗、糖尿病史、颈内动脉IMT、颈动脉斑块数是影响急性脑梗死患者静脉溶栓成效的重要因素。结论：发病年龄、发病-溶栓时间窗、糖尿病史、颈内动脉IMT、颈动脉斑块数是影响急性脑梗死患者静脉溶栓能否获得成功的重要因素。结合患者的临床资料和颈动脉超声结果提供的关键信息，可初步预估静脉溶栓的成效，能更充分地评估溶栓治疗的获益风险比。

[1] GAO X,ZHANG J,PENG Y,et al.Admission clinical characteristics and early clinical outcomes among acute ischemic stroke patients[J].J Biomed Res,2012,26(3):152-158.
[2] O'LEARY D H,POLAK J F,KRONMAL R A,et al.Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults.Cardiovascular Health Study Collaborative Research Group[J].N Engl J Med,1999,340(1):14-22.
[3] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南(2010)[J].中华神经科杂志,2010,43:146-153.
[4] LIU L,WANG D,WONG K S,et al.Stroke and stroke care in China:huge burden,significant wordload,and a national priority[J].Stroke,2011,42(12):3651-3654.
[5] BALDASSARRE D,AMATO M,BONDIOLI A,et al.Carotid artery intima-media thickness measured by ultrasonography in normal clinical practice correlates well with atherosclerosis risk factors[J].Stroke,2000,31(10):2426-2430.
[6] SUN P,DWYER K M,MERZ C N,et al.Blood pressure,LDL cholesterol and intima-media thickness:a test of the "response to injury" hypothesis of atherosclerosis[J].Arterioscler Thromb Vasc Biol,2000,20(8):2005-2010.