不同剂量尿激酶联合降纤酶治疗急性脑梗死效果观察

Two Urokinase Dose Regimens in Combination of Defibrase for Treatment of Acute Cerebral Infarction

目的：探讨不同剂量尿激酶联合降纤酶治疗急性脑梗死的疗效及其安全性。方法：将符合入选条件的300例急性脑梗死按照双盲法随机分为3组,A组给予尿激酶60万单位-150万单位1次静脉滴注,B组给予尿激酶20万单位1日2次静脉注射共5天,两组均在溶栓后应用降纤酶5天;C组单纯用降纤酶。结果：以神经功能缺损评分改善情况判断疗效,治疗后24小时、7天和21天,A组总有效率显著高于B组、C组（P〈0.01）,B组总有效率显著高于C组（P〈0.05）。结论：急性脑梗死6小时内应用尿激酶联合降纤酶治疗,对抢救缺血半暗区脑组织效果显著,尤以大剂量尿激酶单次静脉滴注效果最佳。

Objective：To evaluate the efficacy and safety of different urokinase dose regimens in combination of defibrase for treatment of acute cerebral infarction, Methods ：300 patients with acute cerebral infarction were blindly divided into four groups：Highdose urokinase group （group A ,600 - 1 500 thousand units Ⅳ, daily for 5 days） , Low-dose urokinase group （group B ,200 thousand units IV,bid for 5 days, patients in group A and B received defibrase 5 days after the thrombus dissolved） ,Defibrase-group （group C）. Results：24 hrs,7 days and 21 days after treatment,the recovery of the nervous function was better in group A than in group B ,C （ P 〈0.01 ） and better in group B than in group C（ P 〈0.05 ）. Conclusion：The study suggest within 6 hrs after attack urokinase in combination of defibrase is effective and safety in treatment of acute cerebral infarction ,and the single high-dose urokinase infusion in combination of defibrase is the best regimen.