急性缺血性脑卒中患者超早期溶栓治疗对预后的影响

Effect of ultra early thrombolytic therapy on prognosis in patients with acute ischemic stroke

目的探讨超早期溶栓治疗对急性缺血性脑卒中患者预后的影响。方法选取2018年4月~2020年10月于急诊收治的急性缺血性脑卒中患者60例,随机分为两组,对照组选用低分子肝素钠进行治疗,研究组采用尿激酶进行治疗,对比两组患者NIHSS(美国国立卫生研究院卒中量表)评分及BI(日常生活能力量表)指数以及血液流变学指标的差异。结果两组患者治疗有效率分别为70.0%(对照组)和96.7%(研究组),研究组整体治疗效果较对照组优(P<0.05);治疗前两组患者NIHSS评分及BI指数差异无统计学意义(P>0.05),出院时研究组上述指标较对照组改善明显(P<0.05);两组患者治疗前血液流变学指标差异无统计学意义(P>0.05),出院时均出现下降,研究组全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原值均较对照组低(P<0.05);两组患者治疗后不良反应发生率分别为13.3%(对照组)和10.0%(研究组),两组整体差异不显著(χ2=0.160,P>0.05)。结论超早期尿激酶溶栓治疗急性缺血性脑卒中整体效果良好,可改善患者神经功能,提升日常生活水平,改善血液流变学指标,且具有较高的安全性。

Objective To investigate the effect of ultra early thrombolytic therapy on the prognosis of patients with acute ischemic stroke.Methods 60 patients with acute ischemic stroke treated in emergency department from April 2018 to October 2020 were randomly divided into two groups,the control group was treated with low molecular weight heparin sodium,and the study group was treated with urokinase.The NIHSS(National Institutes of Health Stroke Scale)score,BI(activity of daily living scale)index and hemorheology indexes were compared between the two groups.Results The effective rates of the two groups were 70.0%(control group)and 96.7%(study group),and the overall treatment effect of the study group was better than that of the control group(P<0.05);There was no significant difference in NIHSS score and BI index between the two groups before treatment(P>0.05),but the above indexes in the study group were significantly improved when they were discharged from hospital(P<0.05).There was no significant difference in the hemorheology indexes between the two groups before treatment(P>0.05),but decreased at discharge,the whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and fibrinogen value of the study group were lower than those of the control group(P<0.05);the incidence of adverse reactions in the two groups after treatment was 13.3%(control group)and 10.0%(study group),and the overall difference between the two groups was not significant(χ2=0.160,P>0.05).Conclusion The whole effect of ultra early urokinase thrombolysis in the treatment of acute ischemic stroke is good,which can improve the neurological function,improve the daily living standard and improve the hemorheological indexes,and the treatment with high safety.