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目的探讨大剂量尿激酶治疗急性脑梗死(ACI)患者的疗效、安全性及影响疗效的因素。方法选取2013年5月至2015年3月郑州大学附属郑州市中心医院收治的84例ACI患者作为研究对象,均给予基础治疗,在时间窗内采用大剂量尿激酶进行治疗,评价临床疗效、安全性,分析影响疗效的因素。结果治疗前患者NIHSS评分为(28.0±2.5)分、24 h后(16.6±2.9)分、7 d后(14±6)分、14 d后(10±3)分、28 d后(6.5±1.4)分;治疗后患者血管再通率为100.0%;7 d后,治疗的总有效率为90.5%(76/84);治疗后,颅内出血13例,其他部位出血17例;多因素Logistic回归分析结果显示,BG、溶栓时间窗为影响大剂量尿激酶治疗ACI患者疗效的危险因素。结论大剂量尿激酶溶栓治疗ACI患者临床疗效明显,但出血并发症发生率相对较高,及早溶栓、积极控制血糖有助于改善患者预后。
Objective To investigate the efficacy and safety of high-dose urokinase in the treatment of patients with acute cerebral infarction (ACI) and its influencing factors. Methods Eighty-four patients with ACI admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from May 2013 to March 2015 were enrolled in this study. All patients were given basic treatment and treated with high-dose urokinase within the time window to evaluate the clinical efficacy and safety Sex, analysis of the factors that affect the efficacy. Results The NIHSS score was (28.0 ± 2.5) min before treatment, 16.6 ± 2.9 min after 24 h, 14 ± 6 min after 7 d, 10 ± 3 min after 14 d, and 6.5 ± d after 28 d 1.4). After treatment, the recanalization rate was 100.0%. After 7 days, the total effective rate was 90.5% (76/84). After treatment, intracranial hemorrhage was found in 13 cases and in other parts of hemorrhage in 17 cases. Multivariate logistic regression Regression analysis showed that BG and thrombolytic time window were the risk factors influencing the curative effect of high-dose urokinase in patients with ACI. Conclusion High-dose urokinase thrombolytic therapy in patients with ACI has obvious curative effect, but the incidence of bleeding complications is relatively high. Thrombolytic therapy as soon as possible and positive control of blood glucose can improve the prognosis of patients.