经颈动脉小剂量尿激酶治疗进展性脑梗死的疗效

Curative Effect of Low-Dose Intracarotid Urokinase on Progressive Cerebral Infarction

目的探讨经颈动脉小剂量尿激酶治疗进展性脑梗死的临床疗效及安全性。方法将40例进展性脑梗死患者按治疗方法的不同分为2组:治疗组和对照组,每组20例。2组均采用常规治疗,包括阿司匹林、胞二磷胆碱和甘露醇等。在此基础上,治疗组采用尿激酶治疗。观察2组治疗前,治疗后3、24 h和3、15、30 d的神经功能评分[中国卒中量表(CSS)评分]、脑梗死体积(多田公式计算脑梗死体积)、临床疗效、死亡及脑出血发生的情况。结果与对照组比较,治疗组治疗后3、24 h,3、15 d的CSS得分均明显降低(P<0.05或P<0.01)、治疗后24 h,15、30 d的脑梗死体积均显著缩小(均P<0.01),治疗后30 d总有效率显著提高(P<0.05)。结论经颈动脉小剂量尿激酶治疗进展性脑梗死安全、有效。

Objective To investigate the clinical efficacy and safety of low-dose intracarotid urokinase in the treatment of progressive cerebral infarction. Methods A total of 40 patients with progressive cerebral infarction were randomly divided into treatment group and control group ,with 20 patients in each group.All patients received conventional treatment, including aspirin ,citicoline and mannitol. On this basis,patients in treatment group were given low-dose urokinase. Chinese stroke scale（CSS）scores,infarct volume,clinical efficacy,death and cerebral hemorrhage were observed before and 3 hours,24 hours,3 days and 15 days after treatment.Results Compared with control group, urokinase treatment decreased CSS scores at 3 hours,24 hours,3 days and 15 days after treatment, reduced infarct volume at 24 hours,3 days and 15 days after treatment,and increased total effective rate at 30 days after treatment（P〈0.05 or P〈0.01）.Conclusion Low-dose intracarotid urokinase is safe and effective for progressive cerebral infarction.