盐酸法舒地尔联合尿激酶治疗急性脑梗死的疗效观察

Therapeutic effect of fasudil hydrochloride combined with urokinase in treatment of acute cerebral infarction

目的探讨联合应用盐酸法舒地尔和尿激酶治疗急性脑梗死的疗效和最佳剂量。方法将60例符合溶栓条件的急性脑梗死患者按照随机数字表法分为12h组(20例)、8h组(20例)和对照组(20例)。12h组和8h组患者即在静脉应用尿激酶溶栓的同时每12小时静脉滴入1次30mg盐酸法舒地尔和每8小时静脉滴入30mg盐酸法舒地尔,之后每天依原剂量静脉滴入,盐酸法舒地尔维持治疗14d,对照组则不用盐酸法舒地尔。治疗期间监测患者的血压、意识状态及肢体功能,动态观察凝血时间指标,在治疗后14、30d对所有患者进行欧洲卒中量表(ESS)评分。结果 12h组和8h组患者治疗后神经功能恢复良好,30dESS评分较治疗前明显增加,其中8h组更佳。所有患者均没有观察到明显不能耐受的不良反应。结论联合应用溶栓剂尿激酶和盐酸法舒地尔对脑梗死患者具有良好的治疗作用,其中每8小时静脉滴入1次30mg盐酸法舒地尔效果最佳。

Objective To explore the Therapeutic effect of fasudil hydrochloride combined with urokinase in treatment of acute cerebral infarction and the optimal dose .Methods A total of 60 patients with acute cerebral in-farction and with condition for thrombolytic therapy were randomly divided into 12 h group （20 cases） ,treated with intravenous drip of 30 mg of fasudil hydrochloride once every 12 h ,8 h group （20 cases） ,treated with intravenous drip of 30 mg of fasudil hydrochloride once every 8 h ,and control group （20 cases） .Patients in 12 h group and 8 h group were treated with intravenous drip of urokinase at the same time ,patients in control group were treated with intravenous drip of urokinase alone .Patients in all groups were treated for continuous 14 d .During treatment ,blood pressure ,state of consciousness and limb function were monitored ,and blood coagulation indexes were dynamically observed .After the treatment for 14 and 30 d ,European Stroke Scale （ESS） score were evaluated in all patients .Re-sults After treatment ,neurological function of patients in 12 h group and 8 h group were fine recovered ,ESS score , evaluated at the 30th day were significantly higher than that evaluated before treatment ,which was more effective in 8 h group .No obvious adverse reaction was found in all patients .Conclusion Combined application of urokinase and fasudil hydrochloride might be with fine therapeutic effects for the treatment of cerebral infarction ,and dose of 30 mg every 8 h could be with the best effects .