【摘要】 目的：初步观察静脉溶栓治疗急性脑梗死的效果和安全性。方法：尿激酶（UK）静脉溶栓治疗6小时内急性颈动脉系统脑梗死开放性临床病例研究。结果：选择中重度瘫痪，溶栓治疗前脑CT无早期梗死大块低密度改变患者38例。静脉滴注UK至发病时间4．4±1．1h。UK剂量141±29万UI。溶栓治疗后2小时出现戏剧性神经功能改善7例，24小时主要神经功能缺损改善（欧洲脑卒中评分较溶栓前＞10分）23例。表现血管再闭塞4例。合并症状性脑出血3例，出血性梗死4例。随访3月，基本痊愈14例；轻微神经功能损害8例；中重度神经系统后遗症11例；死亡5例，其中1例死于脑出血。结论：UK静脉溶栓治疗急性脑梗死是安全、有效的。更多还原

【Abstract】 Objective: To investigate the safety and efficacy of intravenous thrombolysis in acute ischemicstroke. Methods: A open trial of intravenous urokinase (UK )thrombolysis in acute carotid artery territory strokewithin 6 hours of symptom onset. Results: All 38 patients had moderate to high-grade hemiparesis and withoutmajor early infarct signs on initial computed tomography (CT). The mean interval to treatment was 4. 4 ± 1. 1hours. The mean dose of UK was 1. 41 ± 0. 29 million units. The dramatic neurological improvement within 2 hoursafter treatment occurred in 7 patients. Major neurological improvement (MNI) at 24 hours (improvement of overl0 points in the European Stroke Scale from baseline values )occurred in 23 patients. Reinfarction syndrome aftermarked improvement were observed in 4 patients. Symptomatic intracerebral hemorrhage occurred in 3 patients.Hemorrhagic infarction without clinical deterioration was detected by follow-up CT in 4 patients. At 3 months, 22patients exhibited complete recovery of only minimal neurologic deficits. 11 patients had moderated or severeneurologic sequelae. and 5 Patients died . in which Ope of them was identified as related to UK therapy. Conclusions:The results suggested that intravenous thrombolytic therapy with UK for acute cerebral infarction might beeffective and safe.[更多还原