超早期不同剂量尿激酶溶栓对脑梗死患者运动神经功能的影响

目的探讨超早期不同剂量尿激酶溶栓对脑梗死患者运动、神经功能的影响。方法以我院收治的65例脑梗死患者为研究对象,均行超早期尿激酶溶栓治疗,根据尿激酶不同剂量分为大剂量组(n=35)与小剂量组(n=30),大剂量组150万U尿激酶静滴,小剂量组25万U尿激酶静滴,比较2组临床疗效、治疗前后运动、神经功能恢复及不良反应情况。结果大剂量组溶栓后28d总有效率82.9%,显著高于小剂量组的43.3%,差异有统计学意义(P0.01)。大剂量组治疗24h、1周、2周FMA评分明显高于同时段小剂量组,NIHSS评分明显低于同时段小剂量组,差异均有统计学意义(P0.01)。大剂量组出血发生率37.1%,与小剂量组的33.3%比较差异无统计学意义(P0.05)。结论大剂量尿激酶超早期溶栓治疗脑梗死疗效较好,能明显促进患者运动及神经功能恢复,且出血发生率较小剂量尿激酶溶栓未明显增加。

Effects of different doses of urokinase thrombolysis at ultra-early period on motor function and neurological function in patients with cerebral infarction

Objective To investigate the effects of different doses of urokinase thrombolysis at ultra‐early period on motor function and neurological function in patients with cerebral infarction .Methods Sixty‐five patients with cerebral infarction trea‐ted by ultra‐early urokinase thrombolysis in our hospital from February 2012 to February 2015 were chosen as the research ob‐jects .According to different doses of urokinase ,35 patients receiving 1 ,500 ,000U urokinase constituted high‐dose group and 30 patients treated with 250 ,000U urokinase composed low‐dose group .The clinical effect ,recovery of motor and neurological function and adverse reactions were compared between the two groups .Results At the 28th day after thrombolysis ,the total ef‐fective rate of the high‐dose group (82 .9% ) was significantly higher than that of the low dose group (43 .3% ) (P<0 .01) .At the each time of observation ,FMA scores of the high‐dose group were significantly higher than those of the low‐dose group ,while the NIHSS scores were significantly lower than those of the low‐dose group (P<0 .01) .In terms of the incidence of bleeding ,no significant difference was found when compared 33 .3% in the low‐dose group with 37 .1% in the high‐dose group (P>0 .05) .Conclusion Application of high‐dose urokinase thrombolysis at ultra‐early stage is of better curative effect in cere‐bral infarction patients ,which can significantly promote the recovery of motor and neurological function with no obvious in‐crease of bleeding compared with low‐dose urokinase .