脑梗死CT值确定溶栓时机的探讨

A investigation on the time of thrombolytic therapy decided by detecting CT value in patients with cerebral infarction

目的 探讨通过脑梗死CT值的测定确定溶栓时机的安全性和有效性。方法 将符合入选标准的 12 1例病例分为 3组 :A组 ,即CT- 溶栓组 (CT没有与神经功能缺失相对应的低密度影像 ) 31例 ;B组 ,即CT+溶栓组 (CT扫描显示与神经功能缺失相对应的低密度影像 ,但CT值测定不低于健侧对应区的 5 0 % ,范围小于大脑中动脉供血区 1 3) 30例 ;C组 ,即对照组 ,患者常规治疗不用溶栓疗法 6 0例。入选溶栓治疗的病例统一用国产尿激酶 (天普洛欣 ,广东天普制药有限公司生产 ) 80～ 10 0万U加入生理盐水 15 0ml静滴 ,静滴时间控制在 2 0～ 30分钟。溶栓后 2 4小时开始口服或鼻饲阿司匹林 ,每日 0 .2～ 0 .3g ,共 10天后改为维持量 ;记录并比较各组治疗前后神经功能缺损评分。结果 CT+溶栓组、CT- 溶栓组与对照组疗效比较差异均有显著性意义 (P <0 .0 5 ) ,对溶栓组 6小时内和大于 6小时的临床资料进行统计学处理 ,2者疗效差异无显著性意义 ,2组无症状性脑出血各 2例 ,差异无显著性意义。结论 通过脑梗死CT值的测定确定溶栓时机的方法安全。

Objective To investigate the safety and availability for the time of thrombolytic therapy decided by detecting CT value in patients with cerebral infarction.Methods 121 patients with acute cerebral infarction were divided into 3 groups according to CT value.31 patients in group A were negatively CT scanned and were treated by 800 000～1 000 000 UK;30 patients in group B were positively CT scanned and were treated by 800 000～1 000 000 UK;60 patients in group C were served as control group and were treated by routine therapy.Results The therapeutic effects of group A and group B were significantly superior to that of group C. Among 61 patients treated by UK,the therapeutic effect less than 6 hours after attack of cerebral infarction was the same as that of more than 6 hours after attack.There was no significant difference in the incidents of cerebral hemorrhage between group A and group B.Conclusion It is safe and effective to decide the time of thrombolytic therapy by detecting the CT value in patients with cerebral infarction.