尿激酶静脉溶栓治疗急性轻型缺血性脑卒中的近期疗效观察

Short-term efficacy observation of intravenous thrombolytic therapy with urokinase in the treatment of acute mild ischemic stroke

目的观察尿激酶静脉溶栓治疗早期轻型急性缺血性脑卒中的疗效及安全性。方法将85例早期轻型缺血性脑卒中随机分为溶栓组(观察组)及非溶栓组(对照组),观察组患者入院给予尿激酶(80~120)万u溶于150 ml的生理盐水中半小时内静脉滴注,24 h后复查无颅内出血予阿司匹林肠溶片100 mg一日一次口服,血栓通注射液500 mg一日一次静滴,对照组患者入院即予阿司匹林肠溶片(200~300)mg口服,奥扎格雷钠注射液80 mg、血栓通注射液500 mg一日一次静滴,次日起阿司匹林肠溶片100 mg一日一次口服,两组入院后均予阿托伐他汀钙20 mg一日一次口服。记录两组入院时及治疗1周后NIHSS评分及卒中进展例数。结果两组一般临床资料及在治疗前NIHSS评分无统计学差异,治疗1周后观察组NIHSS评分明显低于对照组,差异有统计学意义;且卒中进展率对照组明显高于观察组。结论在排除溶栓禁忌症谨慎使用尿激酶静脉溶栓治疗早期轻型缺血性脑卒中安全有效,可减少卒中进展。

Objective To observe the efficacy and safety of intravenous thrombolytic therapy with urokinase in the treatment of early mild acute ischemic stroke.Methods Eighty-five patients with early mild ischemic stroke were randomly divided into the thrombolytic group(the observation group)and the non-thrombolytic group(the control group).Patients in the observation group were hospitalized with urokinase 80-1.2 million u dissolved in 150 ml of normal saline.Intravenous infusion within hours,24 hours after the review without intracranial hemorrhage to aspirin enteric-coated tablets 100 mg once a day orally,Xueshuantong injection 500 mg once a day intravenously,the control group patients were admitted to the hospital aspirin enteric-coated tablets 200-300 mg orally,Ozagrel sodium injection 80 mg,Xueshuantong injection 500 mg once a day intravenously,aspirin enteric-coated tablets 100 mg once a dayorally from the next day,both groups were given atorvastatin calcium 20 mg once a dayorally after admission,record two The NIHSS score and the number of stroke progressions at the time of admission and 1 week after treatment.Results There was no significant difference between the general clinical data and the NIHSS score before treatment.The NIHSS score of the observation group was significantly lower than that of the control group after 1 week of treatment.The difference was statistically significant.The control rate of stroke was significantly higher than that of the observation group.Conclusion Careful use of urokinase intravenous thrombolysis for the treatment of early mild ischemic stroke is safe and effective in eliminating thrombolysis contraindications,which can reduce stroke progression.