尿激酶治疗肺栓塞患者的安全性及有效性临床分析

目的探讨尿激酶治疗肺栓塞的安全性及有效性。方法选取本院2010年10月~2013年10月诊治的肺栓塞患者130例,采用数字随机法分为两组,对照组65例患者采用低分子肝素和华法林治疗,观察组65例患者采用低分子肝素、尿激酶、华法林治疗,采用MRC评分评定患者的呼吸困难程度,比较两组的临床疗效、相关指标的改变情况。结果两组治疗后的组织型纤溶酶原激活物活性、D-二聚体含量、纤溶酶原激活物特异性抑制因子活性、MRC评分均显著降低,血氧饱和度显著升高,差异有统计学意义（P〈0.05）。观察组治疗后的组织型纤溶酶原激活物活性、D-二聚体含量、纤溶酶原激活物特异性抑制因子活性、MRC评分均明显低于对照组,血氧饱和度、总有效率均明显高于对照组,差异有统计学意义（P〈0.05）。结论尿激酶是治疗肺栓塞的有效药物,可明显改善患者的相关临床指标和呼吸困难程度,疗效显著,值得临床推广应用。     

NIHSS在脑梗死静脉溶栓中的应用

目的：探讨美国国立卫生研究院卒中量表（NIHSS）在脑梗死尿激酶静脉溶栓中的应用与评估功能恢复的预测价值。方法对发病〈4.5 h急性脑梗死患者符合溶栓条件并家属签字同意后行尿激酶静脉溶栓,在入出院时进行NIHSS评定及90 d后行改良Rankin量表评定临床预后及独立生活能力。结果溶栓前平均NIHSS为（14±5）分,溶栓后24 h平均NIHSS为（7±6）分,差异有统计学意义（P〈0.01）。结论 NIHSS应用于溶栓中可预测临床转归。     

Barium peritonitis

A case of generalized peritonitis, secondary to a perforation of the rectosigmoid colon during barium-enema roentgenography, is presented. The patient required immediate surgical intervention with the prime importance of the treatment being removal of as much of the contaminating materials as possible. This was done successfully with irrigation and wiping, using urokinase solution. Peritoneal lavage with urokinase solution was also carried out in the early postoperative period. Fluid replacement with careful monitoring of fluid and electrolyte balance is essential before, during, and after the surgical procedure. Adequate antibiotic therapy and careful respiratory and nutritional support are also important.     

急性肺栓塞尿激酶2小时静脉溶栓疗效

目的 观察应用尿激酶2h静脉溶栓方法治疗急性肺栓塞患的疗效。方法 经核素肺灌注显像、D—二聚体、彩超及胸部CT等无创诊断技术确诊的25例急性肺栓塞病例，行尿激酶2h法溶栓治疗，应用临床监测及核素肺灌注显像进行疗效分析。结果 尿激酶2h法溶栓治愈8例，显效4例，好转5例，有效4例，无效4例。溶栓过程中患未见严重出血，血压心率平稳，症状明显改善。结论 急性肺栓塞应用尿激酶2h静脉溶栓治疗有良好的临床效果及安全性。     

小剂量尿激酶治疗肺栓塞的临床观察

目的评价小剂量尿激酶治疗肺栓塞的安全性和有效性。方法26例急性肺栓塞呼吸困难明显但无血液动力学异常的患者，进行小剂量的尿激酶静脉溶栓。结果26例中15例显效，占57．69％；5例有效，占19．23％；6例无效，占23．07％。结论小剂量尿激酶静脉溶栓治疗可以较快地改善患者的症状，缩短住院时间，而且安全。     

尿激酶与组织型纤溶酶原激活剂静脉溶栓治疗急性心肌梗塞的对比研究

为比较尿激酶（UK）及组织型纤溶酶原激活剂（t-PA）静脉溶栓辅以阿司匹林及肝素对急性心肌梗塞的效果及其副作用。对急性心肌梗塞患者发病6h内者，42例给予静脉UK15例静脉内t-PA溶栓辅以静脉肝素及阿司匹林治疗。结果表明，t-PA组、UK组临床血管再通率分别为86．7％与57．1％（P＜0．05），前者消化道与呼吸道出血并发症为13．3％，而后者为0（P＜0．05）。本研究提示静脉t-PA溶栓血管再通率显著高于静脉UK，但出血合并症的发生t-PA组显著高于UK组。     

Urokinase-type plasminogen activator (uPA) decreases hepatic SR-BI expression and impairs HDL-mediated reverse cholesterol transport

Objectives

The aim of the present study was to investigate the effect of urokinase-type plasminogen activator (uPA) on the expression of the scavenger receptor class B type I (SR-BI) in hepatocytes, and its impact on the removal of HDL-cholesteryl ester (CE) in the liver.

Methods and results

Huh7 hepatoma cell lines were incubated with increasing concentrations of uPA. uPA dose-dependently decreased SR-BI protein expression, as determined by flow cytometry (FACS) and by Western blot assays, and down-regulated SR-BI gene expression. Functionally, uPA decreased both the cellular binding of HDL to Huh7 hepatocytes, and the selective uptake of CE from HDL, as determined by several methods including BODIPY staining, cellular cholesterol determination and chasing radio-labeled CE transfer from HDL to the cells. These results were further confirmed using primary rat hepatocyes. The effect of uPA on hepatic SR-BI expression was mediated via binding to the uPA receptor (uPAR). In vivo, SR-BI protein and gene expressions were found to be increased in hepatocytes derived from the uPAR-KO mice compared to C57Bl/6 mice, and in parallel HDL-cholesterol levels in plasma derived from uPAR-KO mice were decreased. Moreover, deficiency of uPAR significantly accelerated the plasma decay of injected HDL-[³H]CE.

Conclusions

The results of this study suggest that uPA decreases the removal of HDL-CE in the liver via suppression of the hepatic SR-BI expression. Impaired reverse cholesterol transport (RCT) may result in atherogenic dysfunctional HDL metabolism and may contribute to atherosclerosis development.     

中分子羟乙基淀粉联合小剂量尿激酶治疗急性脑分水岭梗死的疗效观察

目的 观察中分子羟乙基淀粉联合小剂量尿激酶治疗急性脑分水岭梗死（CWI）患者的临床疗效.方法 68例CWI患者随机分为两组,对照组（n=34）在常规治疗措施基础上加用小剂量尿激酶,观察组（n=34）在常规治疗措施基础上加用中分子羟乙基淀粉、小剂量尿激酶联合治疗.比较两组治疗总有效率,治疗前后神经功能缺损程度（NIHSS）和Barthel指数变化情况.结果 观察组治疗总有效率（88.24％）明显高于对照组（67.65％） （x2=7.383,P＜0.05）;两组患者治疗前NIHSS、Bar-thel比较差异无统计学意义（P＞0.05）,随治疗时间延长,NIHSS逐渐降低,Barthel逐渐升高,且观察组降低和升高较对照组更为显著（P＜0.05）;两组治疗期间未见严重不良反应发生.结论 中分子羟乙基淀粉联合小剂量尿激酶治疗CWI疗效显著,可明显改善神经功能缺损程度和日常生活能力,值得临床推广应用.     

地塞米松联合尿激酶治疗结核性胸膜炎的临床疗效

目的：探讨地塞米松联合尿激酶治疗结核性胸膜炎的临床疗效。方法结核性胸膜炎120例根据入院单双号顺序平分为治疗组与对照组各60例,两组都采用中心静脉导管胸腔置入术,对照组胸腔内注入地塞米松治疗,治疗组胸腔内注入地塞米松联合尿激酶治疗。结果治疗组与对照组的有效率分别为83.3%、66.7%,组间对比有明显差异（P＜0.05）。治疗后治疗组的躯体评分、心理功能、症状与副作用、社会功能评分明显高于对照组,差异有统计学意义（P＜0.05）。结论地塞米松联合尿激酶治疗结核性胸膜炎有很好的疗效,可有效改善患者的生活质量,有很好的临床推广价值。     

脑出血微创钻孔引流与尿激酶对颅内血块溶解的效果对比

目的:对比脑出血微创钻孔引流与尿激酶对颅内血块溶解的效果。方法:2018年4月至2019年4月选择在本院诊治的脑出血患者84例,随机分为两组。研究组给予微创钻孔引流治疗,对照组给予尿激酶治疗,记录颅内血块溶解效果。结果:治疗后观察组的总有效率显著高于对照组(P<0.05);治疗后观察组的血肿清除率显著高于对照组(P<0.05);治疗后两组的血清GFAP含量都显著低于治疗前,观察组也显著低于对照组(P<0.05);观察组闭管时间及引流时间都显著少于对照组(P<0.05)。结论:相对于尿激酶,微创钻孔引流在脑出血中的应用能促进颅内血块溶解,抑制血清GFAP的释放,减少闭管时间及引流时间,从而提高治疗效果。