CT脑灌注成像指导下尿激酶和rt-PA对急性前循环脑梗死静脉溶栓治疗的对比研究

The Comparative Study of Efficacy on Thrombolytic Therapy with Acute Anterior Circulation Cerebral Infarction by Urokinase,Alteplase Guiled by CT Cerebral Perfusion Imaging

目的探讨以CT脑灌注成像(CTP)指导下尿激酶和重组组织型纤溶酶原激活剂(rt-PA)对急性前循环脑梗死静脉溶栓治疗的效果和出血转化率。方法对112例发病3h内前循环脑梗死患者给予随机分组,即尿激酶组和rt-PA组,分别使用尿激酶和rt-PA给予CT脑灌注成像指导下的静脉溶栓,并进行治疗前后血管再通评价、神经功能缺损评分(NIHSS)、ADL评分和出血转化率的比较。结果 112例患者溶栓治疗后NIHSS评分、ADL评分均较治疗前明显改善(P<0.05);尿激酶组和rt-PA组的血管再通率均升高,出血转化率相当(P>0.05)。结论 CTP可以用来指导急性前循环脑梗死静脉溶栓,且尿激酶和rt-PA作用相当,出血转化率无差别。

Objective To assess the efficacy and safety of Urokinase and r-tPA veins thrombolysis treatment under the supervision of CT perfusion in cerebral infarction patients. Methods According to the guideline for cerebrovascular disease prevention and treatment in China, 112 anterior circulation cere- bral infarction patients who were suitable for veins thrombolysis were check with CT perfusion （CTP） be- {ore Urokinase and r-tPA treatment. NIHSS and ADL was evaluated after 24 hours and 7 and 21 days of treatment, respectively. Results A total of 112 patients were treated with Urokinase and r-tPA. The scores by NIHSS were increased after treatment, ADL of The patients improved after treatment （P〈0. 05）,there was no difference of two groups. Conclusions CTP can be applied for thrombolysis treatment in anterior circulation cerebral infarction, There are no significantly difference in the Urokinase and r-tPA with definite efficacy and safety.