超早期尿激酶溶栓治疗脑梗死的临床研究

目的评价超早期应用尿激酶(UK)2.0万U/kg溶栓治疗脑梗死的临床疗效及安全性。方法采用国产UK 2.0万U/kg静脉滴注,对66例发病6h内的脑梗死患者进行溶栓治疗,比较治疗前后神经功能缺损评分(NFDI)。另设60例普通治疗病人作为对照组。结果溶栓后2h NFDI为21.39±2.81,较溶栓前25.96±3.29明显减少(P<0.001),治疗后21d溶栓组NFDI为19.01±3.35,明显低于对照组22.67±3.68(P<0.001)。治疗后21d溶栓组的治愈率、显效率、总有效率分别为30.3%、66.7%、83.3%显著高于对照组13.3%、30%、46.7%,两组比较有显著性差异(均P<0.01)。结论在严格掌握溶栓治疗适应证基础上,应用国产UK 2.0万U/kg超早期静脉溶栓治疗脑梗死临床疗效好,并发症少。

Clinical Study on Ultra-early Intravenous Thrombolysis with Urokinase in Treatment of Cerebral Infarction

Objective To evaluate the clinical effect and safety of ultra-early intravenousd thormbolysis with urokinase in treatment of cerebral infarction.Methods Nerve function defect integral(NFDI) was compared in 66 patients before and after thrombolysis with urokinase 2.0×10~4U/kg intravenous drip within 6h after cerebral nfarction onset.Meanwhile another 60 cases with cerebral infarction treated with routine drugs were served as control.Results The NFDI examined 2h and 21 days after thrombolysis was markedly lower than that before thrombolysis(21.39±2.81,19.01±3.35 Vs 25.96±3.29,P<0.001) and the control group(26.37±3.99,22.67±3.68,P<0.001).A remarkable difference was noticed between them.The cure rate,the effectual rate and the total effective rate evaluated 21 days after thrombolysis were all higher than those in control group(30.3%,66.7% and 83.3% Vs 13.3%,30% and 46.7%,respectively.P<0.01).Conclusions This study revealed that ultra-early intravenous thrombolysis with urokinase 2.0×10~4U/kg in the treatment of cerebral infarction has a better clinical curative effect and less complication when the indications are strictly controlled.