了解北京地区参与急性缺血性卒中（AIS）救治的临床医师对轻型缺血性卒中（MIS）的认知程度和做出静脉溶栓治疗决策的考量因素。

于2023年4月至6月，采用问卷星对北京地区参与AIS救治的临床医师进行匿名网络问卷调查。用SPSS 20.0软件对MIS占比、定义和分类的认知，指南推荐MIS静脉溶栓治疗的认可度，是否选择静脉溶栓治疗的考量因素进行统计分析。

收集来自80家医院的有效调查问卷共303份，有效问卷率为100%。认为MIS在AIS中占比<30%、30%~<40%和40%~<50%的医师比例分别为15.84%、38.61%和17.49%。87.13%的医师认可“轻型致残性患者进行溶栓治疗”，48.51%的医师认可“轻型非致残患者不溶栓”。在医师支持MIS静脉溶栓的考量因素中：从患者角度出发，由高到低前3位依次是“症状致残”（95.38%）、“症状逐渐进展/迅速进展”（94.06%）和“对日常工作和生活的影响”（90.76%）；从医师自身角度出发，由高到低前3位依次是“病情有加重/进展的可能”（97.03%）、“患者症状致残”（93.73%）和“MIS溶栓出血风险低”（72.94%）。在医师不支持MIS静脉溶栓的考量因素中：从患者角度出发，由高到低前3位依次是“合并高出血风险疾病”（90.10%）、“患者及家属不积极/难以沟通”（86.14%）和“合并其他多种疾病”（81.52%）；从医师自身角度出发，由高到低前3位依次是“患者存在相对禁忌”（67.99%）、“部分患者属于非致残”（56.44%）和“担心出血风险”（41.91%）。认为MIS静脉溶栓导致症状性脑出血（sICH）风险<1.0%、1.0%~<2.0%、2.0%~<3.0%、3.0%~<4.0%、4.0%~<5.0%和≥5.0%的医师比例分别为43.56%、20.46%、14.85%、9.57%、2.64%和8.91%。

“症状致残”是医师支持MIS患者静脉溶栓的首要考量因素。部分临床医师对MIS占比、预后及溶栓出血风险缺乏充分的认识，可能高估了MIS静脉溶栓发生sICH的风险。

To investigate the understanding of minor ischemic stroke (MIS) among clinicians involved in acute ischemic stroke (AIS) care in Beijing and to identify the key factors influencing their decision-making regarding intravenous thrombolysis (IVT) for these patients.

An online questionnaire survey was conducted among clinicians participating in AIS treatment in Beijing from April to June 2023 by SoJump. Statistical analysis was performed using SPSS 20.0 software, focusing on: 1) knowledge of MIS prevalence, definition, and classification; 2) guideline recommendations for IVT in MIS; 3) factors influencing IVT decision-making.

A total of 303 valid questionnaires were collected from 80 hospitals, with a valid questionnaire rate of 100%. The proportions of clinicians who believed that MIS accounted for less than 30%, 30%-<40% and 40%- <50% in AIS were 15.84%, 38.61% and 17.49%, respectively. Concerning guideline recommendation, 87.13% of clinicians approved of "thrombolytic therapy for mild disability patients", while only 48.51% of clinicians approved of "no thrombolysis for mild non-disabling patients". Among the factors considered by clinicians in supporting MIS IVT, from the patient's perspective, the top three in descending orders were "symptom disability" (95.38%), "gradual/rapid progression of symptoms "(94.06%) and "impact on daily work and life" (90.76%); From the perspective of clinicians themselves, the top three in descending orders were "possibility of worsening or progression of the condition" (97.03%), "disability of patient symptoms" (93.73%), and "low risk of MIS thrombolysis bleeding" (72.94%). Among the factors considered by clinicians who did not support MIS IVT, from the patient's perspective, they were "comorbidity with high-risk bleeding diseases" (90.10%), "patient and family members not actively/difficult to communicate" (86.14%), and "comorbidity with multiple other diseases" (81.52%). From the perspective of clinicians themselves, the following were: "patients had relative contraindications" (67.99%), "some patients were non-disabled" (56.44%), and "concerns about bleeding risk" (41.91%). The proportion of clinicians who believed that the risk of (syndrome intracerebral hemorrhage) sICH during MIS intravenous thrombolysis was <1.0%, 1.0%-<2.0%, 2.0%-<3.0%, 3.0%-<4.0% and 4.0%-<5.0% were 43.56%, 20.46%, 14.85%, 9.57%, 2.64%, and 8.91%, respectively.

"Symptom disability" was the primary factor motivating IVT use for MIS. Knowledge gaps exist among clinicians regarding MIS epidemiology, prognosis, and thrombolysis risks, with a tendency to overestimate sICH risk. Enhanced evidence-based guidance, academic training, and updated diagnostic and therapeutic concepts are needed to ensure appropriate MIS patients receive timely, scientific treatment.