不同时间窗降纤与抗凝治疗急性脑梗死疗效分析

目的　评价不同时间窗降纤、抗凝治疗急性脑梗死的疗效及不良反应。方法　发病在24h内的急性脑梗死患者180例随机分为降纤组(A组)、抗凝组(B组)和对照组(C组);分别给予降纤酶(第1天10U和第3、5天各5U)、低分子量肝素(4 100U腹壁皮下注射, 1日两次,连用10d)、低分子右旋糖酐500ml加丹参24g静脉滴注,每日1次, 10d为1疗程治疗。结果　发病时间≤6h者,欧洲中风神经功能量表评分抗凝组比降纤组高(P<0. 05); 6h后至24h,抗凝组均比降纤组低(P<0. 05);日常生活能力评分无明显差异(P>0. 05),且均无不良反应。结论　发病时间≤6h应用抗凝治疗急性脑梗死效果较好,而在6h后至24h,则降纤效果显著。

Therapeutic effects of anti-coagulating and defibrinolytic treatment of acute cerebral infarction in different time windows

Objective To evaluate the efficacy and adverse effects of anti-coagulating and defibrinolytic actions in the treatment of acute cerebral infarction in the different time windows.Methods 180 cases with acute cerebral infarction within 24 h onset were randomly divided into defibrinolytic group (group A),anti-coagulating group (group B) and control group (group C),who were given protease (10 U on 1st day,5 U on the third and the fifth day respectively),low-weight molecular heparin (4 100 U subcutaneous injection in abdomen,twice a day,for 10 days),500 ml low molecular dextran and 24 g Danshen once a day,for 10 days respeetirely.Results In less than 6 hours of onset,ESS improvement in the group B was significantly higher than that in group A,which was lower than that in group A in 6-24 h(P<0.05).There was no significant difference in Bethel index between groups (P>0.05) and there was no adverse effect.Conclusion The effect of anti-coagulation treatment in less than 6 h of onset is preferred,but the effect of defibrinolytic treatment in 6-24 h is significant.