小剂量尿激酶超时间窗治疗脑梗死临床观察

Thrombolytic Therapy with Broadened Therapeutic Window for Cerebral Infarction with Low-Dose Turokinase

目的 :探讨小剂量尿激酶超时间窗静脉溶栓治疗急性脑梗死的疗效及安全性。方法 :选择 2 4例发病在 7～ 2 4 h内的急性脑梗死患者为对象 (治疗组 ) ,静脉滴注尿激酶 30万 u,1次 /d,连用 3d。观察治疗后 1周脑梗死的头颅 CT表现情况及治疗后 2周神经功能缺损积分和总有效率 ,并与同期住院的常规治疗 2 5例患者作对照 (对照组 )。结果 :治疗组和对照组神经功能缺损治疗前后积分差分别为 1 6.81± 4.33和 1 0 .57± 3.2 6,总有效率分别为 79.1 6%和 52 % ,脑梗死灶的发生率分别为 41 .67%和 72 % ,平均脑梗死灶面积分别为 (1 4 .4± 5.6) cm2 和 (32± 1 8.2 ) cm2 。两组比较显示治疗组明显优于对照组 (P<0 .0 5或 0 .0 1 ) ,两组均无严重并发症发生。结论 :小剂量尿激酶超时间窗治疗急性脑梗死安全有效。

Objective: To determine the clinical curative effect and safety of intravenous thrombolytic therapy with low dose urokinase for the acute cerebral infarction. Methods: 24 patients with acute cerebral infarction were treated with 3×10 4 urokinase, qd×3, as intravenous thrombolytic therapy within 7~24h after the onset. The examination of head CT in a week,the nerve function defection integral and the total effective rate in two weeks were observed. The results were compared with those of conventional treatment in 25 cases. Results: The nerve function defection integral examined after thrombolysis was markedly lower than that before thrombolysis in the therapy group and the never function defection integral examined after conventional therapy was lower than that before therapy. The total effective rate were 79.16% and 52%, respectively,and the cerebral infarction rate were 41.67% and 72%. A remarkable difference ( P <0.05 or 0.01) was noticed between them. Conclusion: Thrombolytic therapy with broadened therapeutic window for acute cerebral infarction with low dose urokinase is beneficial and safe.