高龄急性脑梗死患者尿激酶联合奥扎格雷钠静脉溶栓治疗分析

Analysis of the intravenous urokinase combined with sodium ozagrel thrombolysis in elderly patients with acute cerebral infarction

目的:评估高龄急性脑梗死患者尿激酶联合奥扎格雷钠静脉溶栓治疗的安全性和有效性。方法:将急性脑梗死患者按是否溶栓和年龄分为高龄溶栓治疗组(观察组),非高龄溶栓治疗组(对照组1)以及高龄未溶栓治疗组(对照组2)。观察组和对照组1患者均采用尿激酶联合奥扎格雷钠静脉溶栓治疗,对照组2则采用奥扎格雷钠静脉滴注治疗方法。对所有患者治疗前NIHSS评分、治疗后24小时NIHSS评分、1周后NIHSS评分,以及90d后的生活质量评定进行比较。并比较三组患者出血事件发生率和死亡率。结果:观察组患者短期治疗效果显著好于对照组2患者,而与对照组1患者相似,治疗90 d后观察组患者的功能完全独立率与对照组1和对照组2患者相比,差异无统计学意义(P>0.05)。三组患者出血事件发生率及死亡率差异无统计学意义。结论:高龄急性脑梗死患者采用尿激酶联合奥扎格雷钠静脉溶栓治疗的方法是安全和有效的,但临床推广尚需大样本多中心研究数据的支持。

Objective To evaluate the safety and effective of intravenous urokinase combine with sodium ozagrel thrombolysis in elderly patients with acute cerebral infarction.Method The patients with acute cerebral infarction hospitalized in our hospital were divided into the elderly thrombolysis group（ observation group）,non elderly patients with thrombolytic therapy group（ control1 group） and elderly patients without thrombolytic therapy group（ control 2 group）.The observation group and control 1 group patients were treated by intravenous thrombolytic therapy of urokinase combined with sodium ozagrel,and the control 2 group patients were treated with intravenous sodium ozagrel therapy.To compare the three groups patients＇ NIHSS score before treatment,24 h and 1w after treatment,as well as the modified Rankin Scale（ mRS） score at 90 d,the bleeding events and the mortality.Results The short-term therapeutic effect of the observation group was significantly better than the control 2 group,and was no difference to the control 1 group.The mRS score at 90 d of the observation group had not significantly difference between the control 1group and the control 2 group.There was no difference in the incidence of bleeding events and mortality in the three groups（ P〉0.05）.Conclusion Our study indicates that intravenous urokinase combine with sodium ozagrel as the thrombolytic therapy in treating elderly patients with acute cerebral infarction is effective and safe,but it needs large sample and multi center research data to support the spreading in clinical application.