尿激酶对非老年性脑梗死缺血半暗带相对弥散系数的影响简

目的评价尿激酶对非老年性急性脑梗死缺血半暗带相对弥散系数（rADC）的影响。方法80例18—59岁的急性脑梗死病人随机分为尿激酶组与重组人组织型纤溶酶原激活剂（rt—PA）组各40例，均进行动脉介入溶栓治疗，比较两组病人动脉溶栓手术前后rADC变化、血管再通、临床疗效及并发症情况。结果治疗前两组缺血半暗带内4个感兴趣点的rADC均不存在统计学差异（P〉0．05），两组rADC从a-d点呈明显单调递增趋势（P〈0．05）；治疗后两组4个感兴趣点的rADC均高于治疗前，但差异均无统计学意义（P〉0．05）。两组的血管再通、临床疗效及并发症发生率差异亦均无统计学意义（P〉O．05）。结论尿激酶与rt—PA对非老年性急性脑梗死缺血半暗带rADC的影响无明显差异．尿激酶可在一定程度上替代rt—PA应用于该类病人。

Effect of urokinase on dispersion coefficient of ischemic penumbra in the non-elderly patients with acute cerebral infarction

Objective To evaluate the effect of urokinase （UK） on relative apparent diffusion coefficient （rADC） of ischemic penumbra in the non-elderly patients with acute cerebral infarction. Methods Eighty patients aged from 18 to 59 years old were randomly divided into two groups： the UK group and recombinant tissue-type piasminogen activator （rt-PA） group, 40 patients for each group. All the patients underwent intra-arterial thrombolytic therapy. The rADC changes, revascularization, clinical efficacy and complications before and after the surgery were compared in the two groups. Results There was no significant difference between rADCs of 4 regions of interest （ROI） in the ischemic penumbra before the treatment （P 〉 0.05）, while the rADCs of two groups showed monotonically increasing trend from a to d point of the ROIs （P 〈 0.05）. The rADCs of 4 ROIs after the treatment were all higher than those before the treatment in two groups, but there was no statistically significant difference （P 〉 0.05）. And there was no statistical significance in differences of revascularization, clinical efficacy and complications between the two groups （P 〉 0.05）. Conclusion There is no significant difference in rADC of ischemic penumbra between UK and rt-PA in non-elderly patients with acute cerebral infarction, and UK can replace rt-PA to a certain degree for these patients.