摘要
目的 研究溶栓治疗效果， 疗效与剂量的关系， 治疗时间窗及并发症。方法 对发病后２４ ｈ 内就诊的９１ 例急性脑梗死患者随机分为对照组２７ 例，给予脑保护剂等常规治疗； 尿激酶（ＵＫ） 治疗者共分３ 组， 即ＵＫ ６×１０５ Ｕ （２４ 例） 组、１６×１０５Ｕ （２９ 例） 组、２６×１０５Ｕ （１１ 例） 组， 并于０．５ ｈ 内静点完。在用药前后不同时期以“ＮａｔｉｏｎａｌＩｎｓｔｉｔｕｅｓ ｏｆＨｅａｌｔｈ Ｓｔｒｏｋｅ Ｓｃａｌｅ”进行神经功能缺失评分。结果 溶栓治疗组疗效高于对照组（Ｐ＜ ０．０１）。＜ ６ ｈ 治疗者疗效优于６～２４ ｈ 治疗者。６～２４ ｈ 内治疗者优于对照组。不同剂量组间疗效差异不显著（Ｐ＞ ０．０５）。溶栓治疗并发出血机率ＵＫ ２６×１０５Ｕ 组（４５．５％ ） ＞ ＵＫ １６×１０５ Ｕ 组（１７．２％ ） ＞ ＵＫ ６×１０５ Ｕ 组（８．３％ ）， 差异有显著性（Ｐ＜ ０．０１）。溶栓治疗组１８．８％ 患者在溶栓治疗２４ ｈ 后出现再次梗死。结论 超早期静脉应用ＵＫ 冲击治疗急性脑梗死是可行的，推荐剂量为ＵＫ ６×１０５ Ｕ， 治疗时间窗为２４
Objective\ The aim of our study was to evaluate the efficacy of thromblysis, with dosesresponse and therapeutic time window with complications in acute ischemic stroke patient treated with intravenous urokinase within 24 h of onset of symptom. Methods\ 91 patients were randomly devided into four groups; Intravenous thromblytic therapy was carried out whitin 30 min using urokinase 6×10 5 U in 24 patients as group 1 16×10 5 U in 29 patients, as group 2 26×10 5 U in 11 patients group 3 and 27 control patients as group 4 who only received neuroprotective treatment for ischemic stroke. End points examined included symptomatic and asymptomatic intracranial hematoma, systemic hemorrhages and neurologic outcome at baseline, 30 min, 1 h, 2 h, 24 h, 48 h and 7 10 d. Results\ The result indicated that the thrombolytic theray group could reduce neurolgical damage significantly as compared with the patients of the control group. The recovery of neurological function failed to demonstrate in 6×10 5 U dose group, 16×10 5 U dose group and 26×10 5 U dose group. The patients who received thrombolytic therapy in 6 h of stroke onset recovered significantly as compared with the patients in 6 24h, Hemorrahgic complication occured in 8 3% of patients treated with 6×10 5 U UK, 17 2% of those treated with 16×10 5 U UK, and 45 5% of those treated with 26×10 5 U UK. The recanalized artery developed reocclusion after 24 h from thrombolysic therapy in 18 8% of patients treated with UK. Conclusion\ These results suggested that intraveneous thrombolysis therapy using urokinase in patients with acute ischemic stroke in 24 h of symptom onset was feasible and the suggested dose was 6×10 5 U, therapeutic time windiow was in 24 h of stroke onset.
出处
《中国神经免疫学和神经病学杂志》
CAS
1999年第3期192-197,共6页
Chinese Journal of Neuroimmunology and Neurology
关键词
尿激酶
急性
脑梗死
溶栓治疗
时间窗
出血转化
urokinase
acute cerebral infarction
therapeutic timewindow
hemorrhage transformation
