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目的 评价急性脑梗死 (ACI)发病后 6h尿激酶溶栓与降纤酶治疗的临床疗效。方法 将 96例ACI患者随机分成 3组 ,尿激酶组、降纤酶组、对照组各 32例。尿激酶组予尿激酶 (UK) 10 0～ 15 0万U溶于 0 9%氯化钠溶液 15 0ml30min静滴。降纤酶组予降纤酶 10U加入 0 9%氯化钠溶液 15 0ml静滴 ,对照组采取常规方案治疗。评价治疗前和治疗后 2h、 1d、7d、 14d的神经功能缺损评分及 3个月、 6个月随访Barthel指数评分 ,并比较其安全性。结果 治疗后 2h、 1d、 7d、 14d时神经功能缺损评分UK组较降纤酶组、对照组改善显著 ,降纤酶组 7d、 14d时较对照组改善显著。 3个月、 6个月随访Barthel指数评分 ,尿激酶组、降纤酶组及对照组疗效间差异均有显著性意义。 3组间安全性比较差异无显著性意义。结论 早期ACIUK溶栓治疗起效快、作用强、效果好。降纤酶治疗也有一定疗效。只要严格掌握适应证及药物用量 ,两种治疗均安全可靠
Objective To evaluate the clinical efficacy of urokinase thrombolysis and defibrase therapy at 6 hours after onset of acute cerebral infarction (ACI). Methods 96 cases of ACI patients were randomly divided into 3 groups, urokinase group, defibrase group, control group, 32 cases. Urokinase group urokinase (UK) 10 0 ~ 15 0 U dissolved in 0.9% sodium chloride solution 15ml 30min intravenous infusion. Defibrase group defibrase 10U added 0 9% sodium chloride solution 15ml intravenous infusion, the control group to take conventional regimen. Neurological deficit scores before and 2h, 1d, 7d and 14d after treatment and Barthel index scores at 3 and 6 months were evaluated and their safety was compared. Results After 2h, 1d, 7d and 14d, the neurological deficit score in UK group was significantly improved compared with that in defibrase group and control group. The defibrase group improved significantly at 7d and 14d compared with control group. At 3 months and 6 months follow-up Barthel index score, urokinase group, defibrase group and control group differences were significant. There was no significant difference in safety between the three groups. Conclusion Early ACIUK thrombolytic therapy has rapid onset, strong effect and good effect. Defibrase treatment also has a certain effect. As long as strict indications and drug use, both treatments are safe and reliable