静脉联合应用硫酸镁和尿激酶治疗急性脑梗死的疗效观察

目的 探讨静脉联合应用尿激酶和硫酸镁治疗急性脑梗死的疗效和最佳剂量.方法 将100例急性脑梗死患者按照随机数字表法分为0 mL组(24例)、10 mL组(24例)、20 mL组(24例)和对照组(28例).0 mL组、10 mL组和20mL组患者即在静脉应用尿激酶溶栓的同时静脉泵入0 mL、10 mL、20 mL的硫酸镁,在之后的24 h静滴60 mL硫酸镁,然后每天20 mL静滴,硫酸镁维持治疗14d,对照组则不用硫酸镁.治疗期间监测患者的血压、腱反射,动态观察血清镁浓度,在治疗后30 d和90 d对所有患者进行欧洲卒中量表(ESS)评分.结果 10 mL、20 mL组患者治疗后血清镁浓度能够迅速提升,远期ESS评分较治疗前明显增加,其中20mL组更为有效.所有患者均没有观察到明显的不能耐受的不良反应.结论 静脉联合应用溶栓剂尿激酶和硫酸镁(负荷应用10 mL、20 mL)对脑梗死患者具有良好的治疗作用,其中20 mL负荷量效果最佳.

Effect of intravenous infusion of magnesium sulfate combined with urokinase for treatment of acute cerebral infarction

Objective To evaluate the therapeutic effect of intravenous magnesium sulfate (MgSO4) infusion combined with urokinase (UK) and determine the optimal dose for treatment of acute cerebral infarction (ACI). Methods One hundred patients with AC1 were randomized into 0, 10, 20 mL group and control group (n=24, 24, 24, 28), and the former 3 groups received intravenous loading infusion of 0, 10, or 20 mL of 25% MgSO4 in addition to OK treatment. After the initial dose of MgSO4, the patients in the combined treatment group received intravenous infusion of 60 mL MgSO4 within 24 h, followed by a daily dose of 20 mL for 14 consecutive days. The blood pressure, tendon reflex, and serum magnesium concentration were monitored during the therapy, and European Stroke Scale (ESS) scores of the patients were recorded at 30 and 90 days after the therapy. Results Treatment with 10 and 20 mL 25% MgSO4 in combination with UK resulted in rapid elevation of serum magnesium concentration and an obvious increase in the long-term ESS score, and the effect was especially obvious with 20 mL MgSO4 No severe adverse effect was noted in these patients during the therapy. Conclusion UK combined with intravenous infusion of 10 or 20 mL 25% MgSO4 may produce obvious therapeutic effect in patients with ACI, and a loading dose of MgSO4 at 20 mL can be optimal.