rt-PA联合尿激酶静脉溶栓治疗急性脑梗死的疗效及安全性研究

目的观察重组组织型纤溶酶原激活剂联合尿激酶静脉溶栓治疗急性脑梗死的疗效与安全性。方法选择前循环急性脑梗死患者171例,联合溶栓组46例,单用rt-PA组39例,单用尿激酶组34例,对照组52例。观察治疗前及治疗后14d NIHSS评分,同时观察再梗死率、脑出血率及死亡率。结果 4组治疗后14d分别和治疗前比较,差异有统计学意义(P<0.05);3个溶栓组与对照组14d有效率差异有统计学意义(P<0.05);4组再发脑梗死率、死亡率差异无统计学意义(P>0.05),联合溶栓组脑出血率与单用rt-PA组及单用尿激酶组差异均有统计学意义(P<0.05)。结论 rt-PA联合尿激酶治疗急性脑梗死是安全有效的。

The efficacy and safety of combined thrombolytic therapy with rt-PA and urokinase on patients with acute cerebral infarction

Objective To observe the efficacy and safety of combined thrombolytic therapy with recombinant tissue plasminogen activator （rt-PA）and urokinase（UK） on patients with acute cerebral infarction.Methods 171 hospitalized patients with acute cerebral infarction were assigned into our study and randomly allocated into four groups：combined thrombolysis group （ n=46） ,rt-PA group （ n=39） ,UK group （ n=34） ,and control group （ n=52） . The outcome score were evaluated according to NIHSS before treatment and 14 days after symptom onset .The hemorrhagic transformation ,recurrent infarction and death as the safety indicators were assessed as well.Results There were significant differences in each group before and after 14 days treatment （P〈0.05）.There were significant differences between 3 thrombolysis groups and control group at 14 days about an efficient and satisfactory outcome rate （ P〈0.05） .There were no significant differences in stroke recurrence rate , mortality, symptomatic intracerebral hemorrhage rate and non-symptomatic intracerebral hemorrhage rate （ P〉0.05） .There were significant differences between combined thrombolysis group and rt-PA group （P〈0.05） and between combined thrombolysis group and UK group （ P〈0.05） .Conclusion The combined thrombolytic therapy with rt-PA and UK for the treatment of acute cerebral infarction is safe and effective .