急性脑梗死六小时以内的静脉溶栓治疗

目的：评价尿激酶（UK）对急性脑梗死（发病6h内）的疗效及其安全性，方法：本研究为一多中心，随机、双盲、安慰剂对照临床研究，凡符合入选标准的病人随机分为3组：A组155例接受UK150U，B组162例接受UK100万U，C组148例接受安慰剂。采用欧洲卒中量表（ESS），Barthel指数（BI）及改良Rankin量表（mRS)评价神经功能恢复状况。结果：溶栓后ESS分数迅速增加，3组间有显著差异，颅内非症状性出血率为9．03％（A组）。5．56％（B组），4．73％（C组）。颅内脑实质性出血率为4．52％（A组），3．09％（B组），2．03％（C组）。颅内脑实质性出血死亡率为1．89％（A组＋B组），C组无一例死于实质性出血，结论：UK用于急性脑梗死（发病6h内）有效且相对比较安全。

Intravenous thrombolysis with urokinase for acute cerebral infarctions

Objectives To evaluate the efficacy and safety of urokinase (UK) in treatment of acute cerebral infarctions within 6 hours from the onset. Methods A multicenter, randomized, double blind, and placebo controlled clinical study was performed. Patients consistent with the inclusion criteria were randomized into 3 groups. As Group A (155 cases), receiving UK 1.5 MU, Group B (162 cases) receiving 1. 0 MU, and Group C (148 cases), placebo. European Stroke Scale (ESS), Barthel Index (BI), and modified Rankin Scale (mRS) were used to evaluate the recovery of neurological functions. Results ESS scores increased rapidly after thrombolysis. There was significant difference among 3 groups. Non-symptomatic hemorrhagic rate were 9.03% (Group A), 5.56% (Group B), and 4.73% (Group C). Intraparenchymal hemorrhagic rate were 4.52% (Group A), 3.09% (Group B), and 2.03% (Group C). Mortality rate of intraparenchymal hemorrhage was 1.89% in Group A + Group B, none in Group C. Conclusions UK is effective and relatively safe in treatment of acute cerebral infarctions within 6 hours from the onset.