纤溶酶与小剂量尿激酶治疗短暂性脑缺血发作中的临床对比分析

Clinical comparative analysis of plasmin and small dose urokinase in transient ischemic attack

目的对比观察纤溶酶与小剂量尿激酶治疗短暂性脑缺血发作中的临床效果。方法选取2011年10月至2013年10月诊治的短暂性脑缺血发作患者109例,根据治疗方法不同分为两组,54例患者采用小剂量尿激酶治疗为对照组,55例患者采用纤溶酶治疗为观察组。比较两组患者短暂性脑缺血发作的停止时间、相关指标的改变情况[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)]、治疗效果、不良反应情况。结果治疗后两组患者TT、PT、APTT均有不同程度的升高,而Fib呈现出不同程度的下降;组间治疗后比较,观察组患者TT、PT均明显低于对照组,Fib明显高于对照组,差异有统计学意义(P<0.05),但APTT比较差异无显著性(P>0.05)。观察组短暂性脑缺血发作停止时间明显小于对照组(P<0.05)。观察组患者总有效率98.2%稍高于对照组的96.3%,但差异无统计学意义(P>0.05)。观察组患者不良反应发生率1.8%明显低于对照组的14.8%,差异有显著性(P<0.05)。结论纤溶酶与小剂量尿激酶均是治疗短暂性脑缺血发作的有效药物,但纤溶酶起效更快,不良反应更少,安全性更高。

Objective To investigate clinical effect of plasmin and small dose urokinase in transient ischemic attack. Methods 109 patients with transient ischemic attack were selected in hospital from October 2011 to October 2013. According to treatment methods,patients were divided into two groups. 54 patients treated using small dose urokinase as control group. 55 patients treated using plasmin as observation group. Transient ischemic attack stop time,changes of related index,treatment effect,adverse reactions were compared between two groups. Results After treatment,patients were TT,PT,APTT increased in varying degrees. Fib demonstrated different degrees of decline in the two groups after treatment. TT and PT in patients of the control group were significantly higher than in the observation group. Fib was significantly lower that of observation group.The difference was statistically significant（ P 〈 0. 05）,but APTT was no significant difference（ P〉 0. 05）. Observation group after transient ischemic attack stop time was significantly less than that of the control group（ P 〈 0. 05）. The total efficiency in all patients of 98. 2% is slightly higher than 96. 3%,but the difference was not statistically significant（ P 〉 0. 05）. Observed incidence of adverse reactions in patients of observation group was significantly lower that 1. 8% in the control group. The difference was significant（ P 〈0. 05）. Conclusion Plasmin and small dose urokinase are effective drugs in treatment of transient ischemic attack. Plasmin has faster onset,less adverse reactions,higher security.