小剂量尿激酶治疗急性脑梗塞83例临床分析

Clinical analysis of treatment of acute cerebral infarction with low-dosage urokinase:83 cases observation

目的:观察小剂量尿激酶治疗发病24h内急性脑梗塞患者的临床疗效,并评价小剂量溶栓药在使用过程中的安全性。方法:急性脑梗塞患者168例,随机分为两组,对照组85例采用常规综合治疗14 d,观察组83例采用小剂量尿激酶(20万U)静脉滴注,连续7 d,其余治疗同对照组,分别于治疗前及治疗后3、7、14 d进行神经功能缺损评分(ESS),并比较两组疗效。结果:观察组治疗后第3天起ESS积分明显升高,对照组升高不明显;治疗1个月后观察组基本痊愈率(56.63%)明显高于对照组(34.12%)(P<0.05),总有效率(90.36%)亦明显高于对照组(71.16%)(P<0.05)。治疗1个月后,观察组无1例再梗塞,对照组4例无再梗塞,两组差异有统计学意义(P<0.05)。结论:多次小剂量(20万U)尿激酶静脉溶栓治疗疗效优于单纯常规内科综合治疗,且神经功能恢复时间显著缩短,是一种有效、安全的治疗方法,值得在临床上进一步推广应用。

Objective： To observe the clinical effect of the treatment with low-dosage urokinase for acute cerebral infarction in 24h. Methods： Randomly separated 168 patients with acute cerebral infarction into control group （85 cases） and observation group （83 cases）. Patients in control group were treated with routine combined therapy for 14d, while patients in observation group were treated by intravenous drip with low-dosage urokinase for 7d apart from the routine combined therapy. Evaluated the results before and on the 3rd, 7th and 14th day after the therapy according to National Institutes of Health Stroke Scale （ NIHSS）, and compared effects of both groups. Results： The ESS score increased significantly from the 3rd day in observation group, while the variation was insignificant in control group. 1 month later after treatment, all patients in observation got healed, with significantly higher healing rate （56.63%） and higher total efficiency （90.36%） than control group（P 〈 0.05 ）. No patient in observation group had recurrence, while only 4 patients were free of recurrence in control group, with significant difference between two groups （ P 〈 0.05 ）. Conclusion ： Intravenous thrombolytic therapy with low-dosage urokinase （200000U） by several times is more effective than simple routine combined therapy, and with shorten recovery time for neural function. It is safe and effective, and valuable for clinical application.