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目的探讨重组组织型纤溶酶原激活物(rt-PA)与尿激酶分组静脉治疗急性脑梗死的疗效及安全性。方法选择急性及脑梗死患者53例,美国国立卫生研究院卒中量表(NIHSS)评分6~20分,发病时间1~5 h,无溶栓禁忌证。按起病时间分为两组:rt-PA50 mg(0.6~0.8 mg/kg)组(A组)和UK150万U组(B组)。比较两组治疗前及治疗后1 h、1 d、7 d、21 d的NIHSS评分改善率(≥4分)及颅内出血率、病死率情况。结果 A组治疗后21 d NIHSS评分改善率(68.8%)明显优于B组(57.1%);A组发生颅内出血的比例为3.1%,B组发生颅内出血的比例为4.8%;B组病死率(14.3%)略高于A组(9.4%)。rt-PA组治愈率为46.9%,显效率为68.8%,无效率为31.2%;UK组治愈率为38.0%,显效率为57.1%,无效率为42.9%。结论 rt-PA与尿激酶分组静脉溶栓治疗6 h内急性脑梗死安全有效,并能改善预后。
Objective To investigate the efficacy and safety of recombinant tissue plasminogen activator (rt-PA) and urokinase in the treatment of acute cerebral infarction. Methods Fifty-three patients with acute and cerebral infarction were selected. NIHSS score was 6 to 20 and onset time was 1 to 5 hours. There was no contraindication to thrombolysis. According to the onset time is divided into two groups: rt-PA50 mg (0.6 ~ 0.8 mg / kg) group (A group) and the UK1500 U group (B). The NIHSS score improvement rate (≥4 points) and intracranial hemorrhage rate and case fatality rate before treatment and 1h, 1d, 7d, 21d after treatment were compared between the two groups. Results The improvement rate of NIHSS score (68.8%) in group A at 21 d was significantly better than that in group B (57.1%). The incidence of intracranial hemorrhage in group A was 3.1% and that in group B was 4.8% Rate (14.3%) was slightly higher than in group A (9.4%). The cure rate of rt-PA group was 46.9%, the effective rate was 68.8%, the inefficiency rate was 31.2%. The cure rate of UK group was 38.0%, the effective rate was 57.1% and the inefficiency rate was 42.9%. Conclusion rt-PA and urokinase group intravenous thrombolysis within 6 h of acute cerebral infarction safe and effective, and can improve the prognosis.