尿激酶溶栓治疗急性脑梗死后出血的临床效果分析

Analysis on clinical effects of urokinase thrombolytic therapy in treating hemorrhage after acute cerebral infarction

目的探讨尿激酶溶栓治疗急性脑梗死后出血的临床效果与相关机制。方法 78例急性脑梗死后出血患者分为观察组与对照组各39例,对照组应用重组组织型纤溶酶原激活剂溶栓治疗,观察组应用尿激酶溶栓治疗,评定两组预后疗效、并发症发生情况与美国国立卫生研究院卒中量表(NIHSS)评分、血清基质金属蛋白酶-9(MMP-9)变化情况。结果治疗后观察组与对照组NIHSS评分都明显低于治疗前(P<0.05),血清MMP-9水平都明显低于治疗前(P<0.05),同时组间对比差异有统计学意义(P<0.05)。对照组和观察组的总有效率是82.1%、94.9%,差异有统计学意义(P<0.05)。观察组治疗期间并发症发生情况都明显少于对照组(P<0.05)。结论尿激酶溶栓治疗急性脑梗死后出血有很好的效果,其作用的发挥可能与有效促进血清MMP-9水平降低有关。

Objective To investigate the clinical effects of urokinase thrombolytic therapy in cerebral infarction. Methods Seventy-eight patients with hemorrhage after acute cerebral infarction treating hemorrhage in ourhospitai were after acute equally di- vided into the observation group and the control group according to the random number table method. The control group was given the recombinant tissue plasminogen activator thromholytic therapy and the treatment group was given the urokinase thrombolytic therapy. The prognosis,therapeutic effect,occurrence situation of complications,changes of NIHSS scores and serum MMP-9 con- tent were evaluated in the two groups. Results After treatment,the NIHSS scores in the observation group and controtgroup were significantly lower than before treatment（P〈0.05）, serum MMP-9 level was significantly lower than before treatment（P〈0.05）, meanwhile the difference between the two groups was statistically significant（P〈0. 05）. The total effective rate m the control group and observation group were 82. 1% and 94. 9 % respectively （P〈0.05）. The occurrence situation of complications during treatment period in the observation group was significantly less than that in the control group（P〈0.05）. Conclusion The uroki- nase thrombolytic therapy has better effect for treating hemorrhage after acute cerebral infarction, its role may be related to effec- tively decrease the serum MMP-9 level.