r-tPA与尿激酶溶栓治疗急性脑梗死的疗效比较

目的 对比观察重组组织型纤溶酶原激活剂（r-tPA）与尿激酶（UK）溶栓治疗急性脑梗死（ACI）的疗效差异和安全性。方法 将88例ACI患者随机分为r-tPA组、UK组和对照组，分别给予r-tPA、UK溶栓和低分子右旋糖酐治疗。结果 3组治疗前与治疗后4周神经功能缺损程度评分比较，均有显著性差异（P〈0．001和P〈0．05）．r-tPA组的显效率（48．28％）和总有效率（86．21％）稍优于UK组（分别为41．38％和82．76％），但两者比较无显著性差异（P〉0．05）。两组出血并发症及死亡率比较，也无显著性差异（P〉0．05）。结论 r-tPA与UK早期溶栓治疗ACI的近期疗效和安全性相似，远期疗效有待进一步观察。

Intravenous Thrombolysis with r-tPA and UK for Treating Acute Cerebral Infarction

Objective To observe the efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator (r-tPA) and urokinase (UK) for treating patients with acute cerebral infarction(ACI). Methods 88 patients with ACI were randomly divided into r-tPA group, UK group and control group , receiving the treatment of intravenous thrombolysis with r-tPA, UK and dextran-40, respectively. Results There were significant differences in scoring of clinical nerve function in three groups before and after treatment for 4 weeks(P < 0.01 and P < 0.05). The improving rate and total effective rate in r-tPA group, which were 48.28% and 86.21%, respectively, were better than those in UK group, which were 41.38% and 82.76%, respectively. But there were not significant differences between two groups(P > 0.05). The rate of symptomatic intracerebral hemorrhage and the mortality rate had no significant differences between two groups(P > 0.05). Conclusion The efficacy and safety of intravenous thrombolysis with r-tPA and UK for patients with ACI in short-term treatment are similar, but the efficacy in long-term treatment needs to be investigated.