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目的探讨急性脑梗死应用中等剂量尿激酶静脉溶栓治疗的疗效和安全性。方法将90例急性脑梗死患者随机分为3组:中等剂量尿激酶溶栓组、大剂量尿激酶溶栓组和对照组,各30例。对各组患者治疗前后神经功能缺损程度进行评分,比较其疗效。比较中等剂量尿激酶溶栓和大剂量尿激酶溶栓治疗过程中的安全性。结果治疗前3组间神经功能缺损程度评分无统计学差异(P>0.05)。中等剂量和大剂量尿激酶溶栓组治疗后24h、7d神经功能缺损程度评分均显著低于对照组(P均<0.05),但中等剂量与大剂量尿激酶溶栓组间评分相近(P>0.05)。中等剂量尿激酶溶栓组与大剂量尿激酶溶栓组总有效率均高于对照组(90.80%vs63.33%,P<0.05;93.33%vs63.33%,P<0.01),不同剂量溶栓2组间总有效率无统计学差异(P>0.05)。中等剂量尿激酶溶栓组未出现不良反应,大剂量尿激酶溶栓组出现脑出血2例、再灌注损伤1例、血尿1例。结论中等剂量尿激酶静脉溶栓治疗急性脑梗死疗效确切,与大剂量尿激酶治疗相当,且安全性相对较好。
Objective To investigate the curative effect and safety of moderate dose urokinase intravenous thrombolysis in acute cerebral infarction. Methods 90 patients with acute cerebral infarction were randomly divided into 3 groups: medium dose urokinase thrombolytic group, high dose urokinase thrombolytic group and control group, 30 cases each. The scores of neurological deficits in each group before and after treatment were scored and their efficacy was compared. Compare the safety of medium dose urokinase thrombolysis and high dose urokinase thrombolysis. Results There was no significant difference in the scores of neurological deficits between the three groups before treatment (P> 0.05). The scores of neurological impairment at 24h and 7d after middle-dose and high-dose urokinase thrombolytic therapy group were significantly lower than those of control group (all P <0.05), but there were similar scores between middle dose and high-dose urokinase thrombolysis group (P> 0.05). The total effective rate of medium dose urokinase thrombolytic group and high dose urokinase thrombolysis group were higher than that of the control group (90.80% vs63.33%, P <0.05; 93.33% vs63.33%, P <0.01) There was no significant difference in the total effective rate between the two groups (P> 0.05). There was no adverse reaction in medium dose urokinase thrombolytic group, 2 cases of intracerebral hemorrhage in high dose urokinase thrombolysis group, 1 case of reperfusion injury and 1 case of hematuria. Conclusion The moderate dose of urokinase intravenous thrombolysis in the treatment of acute cerebral infarction curative effect is exact, and high-dose urokinase treatment is quite, and the safety is relatively good.