不同剂量尿激酶静脉溶栓治疗脑梗死疗效和安全性分析

Efficacy and Safety of Intravenous Thrombolysis with Different doses of Urokinase in the Treatment of Cerebral Infarction

目的探讨不同剂量尿激酶静脉溶栓治疗脑梗死的临床疗效和安全性。方法方便选取于该院2011年1月—2016年5月收治的脑梗死患者122例为研究对象,依据尿激酶应用剂量随机分组,其中A组(n=62)应用剂量为中剂量(100万IU),B组(n=60)应用剂量为大剂量(150万IU),比较两组临床疗效。结果 A组总有效率为85.4%,B组为83.3%,对比差异无统计学意义(P>0.05)。A组和B组治疗前神经功能缺损评分分别为(16.42±3.74)分和(16.36±3.52)分,差异无统计学意义(P>0.05);A组和B组治疗后24 h后神经功能缺损评分分别为(7.33±1.73)分和(7.24±1.67)分,差异无统计学意义(P>0.05);在治疗后7 d神经功能缺损评分同样差异无统计学意义(P>0.05)。A组与B组治疗后90 d Barthel指数分别为(75.99±19.78)和(74.92±19.18),差异无统计学意义(P>0.05);Rankin评分分别为(2.63±0.57)分和(2.73±0.55)分,差异无统计学意义(P>0.05)。药物安全性:A组不良事件发生率为3.2%,明显低于B组16.6%,对比差异有统计学意义(P<0.05)。结论相较于大剂量(150万IU)尿激酶,中剂量(100万IU)尿激酶静脉溶栓治疗脑梗死的疗效相当,但安全性更高,值得推广。

Objective To investigate the clinical efficacy and safety of intravenous thrombolysis with different doses of urokinase in the treatment of cerebral infarction. Methods Convenient selection a total of 122 patients with cerebral infarction admitted in our hospital from January 2011 to May 2016 were randomly divided into two groups according to the application dose of urokinase. The dose of group A（n = 62） was 1 million IU,the group B n = 60） were treated with high dose（1.5million IU）. The clinical efficacy was compared between the two groups. Results The total effective rate was 85.4% in group A and 83.3% in group B. In group A and group B, the scores of neurological deficits（16.42 ± 3.74）points and（16.36 ±3.52）points were not significantly different（P〉0.05） The neurological deficit scores（7.33 ± 1.73）points and（7.24 ± 1.67）points, respectively, were not significantly different（P〉0.05）; neurological deficit scores at 7 days after treatment given critical（P〉0.05）. Conclusion1. The Barthel index was（75.99 ± 19.78） and（74.92 ± 19.18） at 90 days after treatment in group A and B, respectively（P〉0.05）. Rankin score（2.63 ± 0.57）points And（2.73 ± 0.55）points, respectively, there was no significant difference（P〉0.05）. Drug safety：the incidence of adverse events in group A was 3.2%, significantly lower than that in group B 16.6%（P〈0.05）. Conclusion Compared with large dose（1.5 million IU） of urokinase, middle dose（1 million IU） urokinase intravenous thrombolytic therapy for cerebral infarction is equivalent, but the safety is higher, worthy of promotion.