尿激酶溶栓治疗心源性脑栓塞的临床研究

Chinical study on thormbolysis therapy with urokinase in treatment of cardiogenic cerebral embolism.

目的评价尿激酶(UK)溶栓治疗心源性脑栓塞的临床疗效及安全性。方法采用国产尿激酶100～150万U静脉滴注,对42例发病在6h以内的心源性脑栓塞患者进行溶栓治疗,比较治疗前后神经功能缺损评分(NFDI)。另设40例普通病例作对照组。结果溶栓后2hNFDI为20.12±2.65,较溶栓治疗前26.78±3.42明显减少(P<0.001),治疗后21d溶栓组NFDI为18.21±3.16,明显低于对照组,治疗后21d溶栓治疗组的治愈率、显效率、总有效率分别为33.3%、69%、88.1%,显著高于对照组(15%、32.5%、50%),两组比较有显著差异(P<0.05)。结论在严格掌握溶栓治疗适应症的基础上应用尿激酶静脉溶栓治疗心源性脑栓塞疗效好、并发症少。

Aim To evaluation the clinical effect and safety of thormbolysis therapy with urokinase in treatment of cardiogenic cerebral embolism. Methods Nerve function defect integral was compared in 42 patients before and after thrombolysis with urokinase 1 000-1 500KU intravenous drip within 6h after cardiogenic cerebral embohsm onset. Meanwhile another 40 cases with cardiogenic cerebral embolism treated with routine drugs were served as control. Results The NFDI examined 2h and 21 days after thrombolysis was markedly lower than that before thrombolysis（20.12±2.65,18.21±3.16 Vs 26.78±3.42,P〈0.001） and the control group. A remarkable difference was noticed between them. The cure rate,the effectual rate and the total effective rate evaluated 21 days after thrombolysis were all higher than those in control group （33.3% ,69%, 88.1% ,respectively.）. Conclusions This study revealed that intravenous thrombolysis with urokinase in the treatment of cardiogenic cerebral embolism has a better clinical curative effect and less complication when the indications are strictly controlled.