【摘要】 目的： 观察尿激酶静脉溶栓治疗急性脑梗死的临床有效性及安全性。方法： 应用大剂量尿激酶超早期（发病6小时内）静脉溶栓治疗急性脑梗死23例，于溶栓前及溶栓后2小时、24小时、1个月进行神经功能缺损评分，同时观察脑内及其它系统有无出血并发症。结果： 溶栓后2小时瘫痪肢体肌力提高3级4例，2级8例，1级7例，无变化4例，其中4例24小时内临床症状反复；1个月时，发病4小时内溶栓组与4小时至6小时内溶栓组相比，神经功能缺损评分值（ESS）升高更明显，前者P ＜0．01，后者P ＜0．05，本组有1例大面积脑梗死溶栓后出现非症状性出血性脑梗死，3例于溶栓结束后出现轻微齿龈出血，无1例死亡。结论：大剂量尿激酶静脉溶栓治疗急性脑梗死其疗效较肯定，溶栓开始时间越早，疗效越好，在严格掌握适应证情况下，应用比较安全。更多还原

【Abstract】 Objective：To evaluate the efficacy and safety of intravenous infusion of urokinase for patients with acute cerebral infarction．Methods：Following neurological evaluation and computed tomography scan of the brain, 23 patients with acute cerebral infarction were infused with high dose urokinase,ranging from 10×105 IU to 20×105 IU,within 6 hours after the onset of symptoms．Neurological outcome, incidence of symptomatic or asymptomatic intracranial hematoma, and systemic hemorrhage were evaluated at 2 hours,24 hours,and 1 month after treatment．Results：Twelve patients had major neurological improvement and 7 had slight improvement at 2 hours after the initiation of urokinase, but 4 relapsed within 24 hours． When evaluated at 1 month after thrombolytic treatment,patients received urokinase within 4 hours after the onset had significantly better improvement of ESS than those received the medicine at 4 hours～6 hours．Asymptomatic hemorrhagic infarction only occurred in one patient．Three patients had mild gingival bleeding,but none died．Conclusion：High dose intravenous urokinase thrombolysis could become an effective and safe treatment for acute cerebral infarction within 6 hours after the onset of symptom．更多还原