急性脑梗死超早期溶栓治疗的分析与临床研究

Analysis and Clinical Study of Ultra-early Thrombolytic Therapy for Acute Cerebral Infarction

目的研究分析尿激酶溶栓治疗超早期急性脑梗死(ACI)的疗效与临床意义。方法选取确诊超早期ACI患者172例,将其分为溶栓组和对照组,溶栓组给予1.5×106U尿激酶+200 mL生理盐水,30 min内静脉滴注完;对照组给予复方丹参16 mL+低分子右旋糖酐250 mL,每天1次,疗程2周,余治疗方案两组相同。比较分析两组患者的疗效。结果溶栓组治疗后6 h、3 d、7 d的凝血酶时间(TT)和凝血酶原时间(PT)显著高于对照组,而纤维蛋白原(FIB)显著低于对照组(P<0.05)。溶栓组治疗后1、7、14、28 d的欧洲卒中评分量表(EES)评分显著高于对照组(P>0.05)。溶栓组治疗后基本痊愈率为70.5%,显著高于对照组的45.2%(P>0.05)。溶栓组治疗后90 d Fugl-Meyer量化评分(FMA)和Barthel指数显著高于对照组。结论大剂量尿激酶静脉内溶栓治疗超早期ACI疗效显著、安全,是治疗ACI较理想的选择。

Objective To study the efficacy and clinical significance of urokinase thrombolysis in the treatment of ultra-early acute cerebral infarction(ACI).Methods A total of 172 patients with ultra-early ACI were enrolled.They were divided into thrombolytic group and control group.The thrombolytic group was given 1.5×106 U urokinase+200 mL normal saline.The intravenous infusion was completed within 30 min.Compound Danshen 16 mL+low molecular weight dextran 250 mL,once a day for 2 weeks,the rest of the treatment regimen were the same.The efficacy of the two groups of patients was compared and analyzed.Results Thrombin time(TT)and prothrombin time(PT)were significantly higher in the thrombolytic group at 6 h,3 d,and 7 d after treatment than in the control group,while fibrinogen(FIB)was significantly lower than the control group(P<0.05).The European Stroke Rating Scale(EES)scores at 1,7,14,and 28 days after thrombolysis were significantly higher than those in the control group(P<0.05).The basic cure rate after treatment in the thrombolytic group was 70.5%,which was significantly higher than that in the control group(45.2%)(P<0.05).The FuglMeyer quantification score(FMA)and Barthel index were significantly higher in the thrombolytic group than in the control group 90 days after treatment.Conclusion High-dose urokinase intravenous thrombolysis for the treatment of ultra-early ACI is effective and safe,and it is an ideal choice for the treatment of ACI.