急性脑梗死(6小时)的尿激酶、降纤酶与常规治疗的临床对照研究

Clinical Contrast Study on Urokinase, Defibras and Normal Treatment on Acute Cerebroal Ischemic

目的 评价急性脑梗死 (ACI)发病后 6h尿激酶溶栓与降纤酶治疗的临床疗效。方法 将 96例ACI患者随机分成 3组 ,尿激酶组、降纤酶组、对照组各 32例。尿激酶组予尿激酶 (UK) 10 0～ 15 0万U溶于 0 9%氯化钠溶液 15 0ml30min静滴。降纤酶组予降纤酶 10U加入 0 9%氯化钠溶液 15 0ml静滴 ,对照组采取常规方案治疗。评价治疗前和治疗后 2h、 1d、7d、 14d的神经功能缺损评分及 3个月、 6个月随访Barthel指数评分 ,并比较其安全性。结果 治疗后 2h、 1d、 7d、 14d时神经功能缺损评分UK组较降纤酶组、对照组改善显著 ,降纤酶组 7d、 14d时较对照组改善显著。 3个月、 6个月随访Barthel指数评分 ,尿激酶组、降纤酶组及对照组疗效间差异均有显著性意义。 3组间安全性比较差异无显著性意义。结论 早期ACIUK溶栓治疗起效快、作用强、效果好。降纤酶治疗也有一定疗效。只要严格掌握适应证及药物用量 。

Objective To analyze the clinical effect on Urokinase and Defibrase in treating acute ischemic cerebrovascular disease (ACI) in 6 h.Methods 96 ACI cases in 6h were divided in three groups: UK group. Defibrase group and control group.UK group were treated with UK 100～150×104 U in InjNS150 ml (ivgtt in 30 minutes). Defibrasegroup were treated with 10 U in InjNS150 ml (ivgtt in 60 minutes). Control group were treated with ordinary method. All patients were assessed with the handicap of neural function before treating and 2 h1, 7, 14 days after treating. And the security was evaluated.Results The handicap of neural function of UK group were significantly higher than defibrase group and control group 2 h,1, 7, 14 days after treating. The handicap of neural function of defibrase group were significantly higher than control group. The Barthel Index of UK groups was higher than defibrase group and control group, and the Barthel Index of defibrase group was higher than control group 7, 14 days after treatment. There was no significant difference among three groups in bleeding side effect.Conclusion Therapy of UK adopted soon after the onset of AIC is a safe, effective method. Defibrase shows effective too. Both remedies were safe under strict control in drug dosage and adaptable symptom.