尿激酶联合低分子肝素钙治疗进展性脑梗死62例疗效观察

Effects of urokinase and low-molecular-weight heparins calcium in 62 cases of acute cerebral infarction

目的 探讨尿激酶（uK）联合低分子肝素钙治疗进展性脑梗死的疗效和安全性。方法 对发病6h后病情继续发展的急性脑梗死患者62例，随机分为治疗组和对照组，治疗组首剂给予尿激酶30万U，第2、3天各20万U分别溶于生理盐水100ml中静滴，30min内滴完；UK滴注后6h给予低分子肝素钙5000IU脐周皮下注射，连用1周。同时给予胞二磷胆碱、25％甘露醇、阿司匹林等常规药物治疗。对照组除不采用UK外，其余治疗与治疗组相同。结果 治疗组疗效优于对照组（P〈0．01），治疗组治疗后24h、72h、14d神经功能状态评分较治疗前明显改善（P〈0．01），病情进展控制较好，而对照组虽有改善但差异无统计学意义（P〉0．05）。结论 UK联合低分子肝素钙治疗进展性急性脑梗死疗效肯定，安全性好。

Objective To discuss the efficiency and safety of urokinase（UK） combining with low-molecularweight heparius ealcium（LMWH Ca）. Methods 62 cases were randomly divided into two groups： treatment group and control group. All the patients suffered from acute cerebral infarction （CI） and the situation was progressive 6 hours after incidence. Patients in the treatment group were treated with UK introveinously at the dosage of 0.3,0. 2,0.2 million units for the 1st, 2nd,3rd day respectively, UK was dissolved in 100ml sodium chloride solution and was finished in 30 minutes. 6 hours after UK treatment,5000IU of LMWH Ca medication were followed via subcutaneous injection for one week. Citicoline,25 % mannitol or aspirin were medicated in necessary. Control group was medicated in the same way except for UK. Results The effects of treatment of treatment group were better than control group. 24h,72h or 14d after medication, nerve functional insufficient assessment scales of patients in treatment group were improved significantly（ P 〈 0.01 ）. Control group improved also but not significantly. Conclusion The efficiency and safety of UK combining with LMWH Ca in treatment of CI patients were affirmed.