Shi Y, Li D, Zhao Y
Department of Neurology, Tengzhou Central People's Hospital, Shandong 277500 China.
Zhonghua Yi Xue Za Zhi. 2000 Feb;80(2):101-3.
To determine the clinical curative effect and safety of ultra-early intravenous thrombolysis with high-dose urokinase in treatment of acute cerebral infarction.
Thirty-one patients with atherosclerotic cerebral infarction were treated with a single dose of 1.5 x 10(4) U/kg urokinase as intravenous thrombolytic therapy within 6 h after the onset. The decrease degree of nerve function defect integral, the cure rate, the effectual rate, and the total effective rate were observed 3 h and 21 days after thrombolysis, respectively, and the results were compared with those of conventional treatment. The infarct volume of patients treated with the two therapies were compared 21 days after treatment.
The nerve function defect integral examined 3 h after thrombolysis (14.2 +/- 2.1) was markedly lower than that before thrombolysis (26.5 +/- 9.1). A remarkable difference (n = 31, t = 4.669, P < 0.05) was noticed between them. The cure rate and effectual rate reached 22.58% (7/31) and 67.74% (21/31), respectively. The decrease degree of nerve function defect integral, the cure rate, the effectual rate and the total effective rate evaluated 21 days after thrombolysis were all higher than those of conventional therapy group (from 26.5 +/- 9.1 to 8.8 +/- 2.8 vs from 26.4 +/- 8.1 to 16.3 +/- 4.1, t = 2.417; 51.61% vs 15. 38%, chi(2) = 5.037; 70.96% vs 42.30%, chi(2) = 4.765; 87.09% vs 65.38%, chi(2) = 3.886, respectively; all P < 0.05). The infarct volume was markedly smaller than that of the conventional therapy group (3.7 cm 3 +/- 3.0 cm(3) vs 5.3 cm(3) +/- 3.1 cm(3), t = 2.165, P < 0.05).
Ultra-early intravenous thrombolysis with a single dose of 1.5x10(4) U/kg urokinase in the treatment of atherosclerotic cerebral infarction has a better clinical curative effect and less complication, and it can also have the infarct volume markedly reduced.
探讨大剂量尿激酶超早期静脉溶栓治疗急性脑梗死的临床疗效及安全性。
31例动脉粥样硬化性脑梗死患者在发病6小时内给予1.5×10⁴U/kg尿激酶单次静脉溶栓治疗。分别于溶栓后3小时及21天观察神经功能缺损积分减少程度、治愈率、显效率及总有效率，并与常规治疗组进行比较。治疗21天后比较两组患者的梗死体积。
溶栓后3小时神经功能缺损积分（14.2±2.1）明显低于溶栓前（26.5±9.1），差异有统计学意义（n = 31，t = 4.669，P < 0.05）。治愈率和显效率分别达22.58%（7/31）和67.74%（21/31）。溶栓后21天神经功能缺损积分减少程度、治愈率、显效率及总有效率均高于常规治疗组（从26.5±9.1降至8.8±2.8 对比 从26.4±8.1降至16.3±4.1，t = 2.417；51.61%对比15.38%，χ² = 5.037；70.96%对比42.30%，χ² = 4.765；87.09%对比65.38%，χ² = 3.886，P均< 0.05）。梗死体积明显小于常规治疗组（3.7 cm³±3.0 cm³对比5.3 cm³±3.1 cm³，t = 2.165, P < 0.05）。
单次静脉注射1.5×10⁴U/kg尿激酶超早期治疗动脉粥样硬化性脑梗死临床疗效较好，并发症少，且能显著缩小梗死体积。
