56例心源性脑栓塞患者静脉溶栓治疗的疗效观察

目的观察大剂量尿激酶静脉溶栓治疗心源性脑栓塞的疗效及安全性。方法将109例心源性脑栓塞患者分为2组，溶栓组56例，对照组53例，溶栓组使用尿激酶100-150万单位加入100ml生理盐水中静脉溶栓治疗，非溶栓组（对照组）使用抗血小板聚集或抗凝治疗，并观察疗效。结果2组患者治疗后均减少了缺血性脑卒中的神经功能缺损评分，治疗前后比较有显著性差异（P〈0.05），且溶栓组较非溶栓组疗效为佳（P〈0.05），但2组出血转化发生率无显著性差异（P〉0.05）。进一步分析2组的医疗费用，溶栓组平均费用（6235.3±568.2）元，非溶栓组平均费用（8215.0±318.5）元，两组产生的医疗费用比较有显著性差异（P〈0.05）。结论大剂量尿激酶静脉溶栓治疗能有效改善心源性脑栓塞患者的神经功能，相对于抗凝或抗血小板聚集等抗栓方案，能减少患者医疗费用支出，而溶栓组和非溶栓组的出血转化发生率无明显差异。

An efficacy study of intravenous thrombolytic therapy in 56 patients with cardiogenic cerebral embolism

Objective To observe the efficacy and safety of intravenous thrombolytic therapy with high dose urokinase on cardiogenic cerebral embolism （CCE）. Methods A retrospective analysis of the treatment effects of 109 cases with CCE was performed in the study. The patients were randomly divided into intravenous thrombolytic therapy group （56 patients） and control group （53 patients）. The intravenous thrombolytic therapy group was given 100-150 million units urokinase, while the control group was given antiplatelet or anticoagulant. Results The neurological functions of cerebral ischemic stroke of the 2 groups were significantly improved after treatment （P〈0.05）, however the effect of intravenous thrombolytic theraty group group was better （P〈0. 05）, and hemorrhagic transformation of the 2 groups had no significant difference （P〉0.05）. Further analysis about medical costs showed significant difference between the two group： the thrombolytic therapy group cost 6235. 3 ± 568. 2 yuan on average, while the control group cost 8215 ± 318. 5 yuan instead （P〈0. 05）. Conclusions Intravenous thrombolytic therapy with high dose urokinase could be more effective and safe to improve the nerve function of patients with CCE and have less the medical costs than antiplatelet or anticoagulant therapy. Moreover there was no significant difference in the incidence of hemorrhagic transformation between the two groups.