尿激酶溶栓治疗早期急性脑梗死的疗效

Clinical observation of treatment through intravenous thrombolysis with urokinase for patients with early acute cerebral infarction

目的评价在急性脑梗死(ACI)病后6h尿激酶(UK)静脉溶栓的临床疗效。方法78例ACI随机分成UK组和对照组。UK组UK25万U静脉注射,续以UK150万U60min内静脉滴注,对照组采用通常的治疗方案,评价治疗前和治疗后1、7、14、28d的神经功能缺损评分。结果①治疗后1、7、14、28d时UK组与对照组比较改善均非常显著(P<0.01);7d时UK组改善比较显著(P<0.05);②UK组用药前与用药后1d比较、7d与14d比较、14d与28d比较,神经功能缺损评分改善均非常显著(P<0.01),用药1d与7d比较,差异显著(P<0.05);③UK组用药后1d时显效率23.3%,7d时56.1%,14d时80.3%,28d时91.6%,均高于同期对照组结果(P<0.01、<0.01、<0.01、<0.05)。结论早期ACIUK溶栓治疗比常规治疗起效快、作用强、效果好,并且安全、简便、可靠。

Objective To evaluate efficacy of intravenous thrombolysis with urokinase (UK) in treatment of early acute cerebral infarction (ACI). Methods The 78 patients with ACI onseting within 6 hours were randomizd into two groups UK(regime) group and control group. UK group was given included 250 000 units UK intravenous injection and then 1 500 000 units intravenous dripping. Neurologic defect scoring system was used to evaluate patients responses at admission, and at 24 hours, one week, two weeks as well as 4 weeks after treatment. Results Significant improvement of neurologic defect scorings happened in both groups between 24 hours and 4 weeks after treatment. As for the improvement of neurologic defect scoring, there were significant differences between both groups at 24 hours, 1st week, 2nd weeks and 4th weeks of post dosing respectively (P<0.01). Response rates for UK group were 23.3% at 24 hours of dosing, 56.1% at 1st week, 80.3% at 2nd week, 91.6% at 4th week, significantly higher than those of the control (P<0.01,<0.01, <0.01, <0.05). Conclusions Thrombolysis applied to patients with early ACI is a more effective than the conventional modalities, and is safe, reliable and convenient.