【摘要】 目的 :研究不同用法尿激酶静脉溶栓治疗急性脑梗塞的临床疗效和凝血及纤溶指标的动态变化。方法 :发病 6h内的脑梗塞病人 97例分为大剂量冲击组 44例、小剂量分次给药组 2 8例、对照组 2 5例。在溶栓前后动态记录患者ESS及TT、PT、APTT、FIB、D D、GMP 14 0、FDP等。结果 :溶栓后一个月ESS冲击组由 5 1 81增至 90 89;分次组由 5 3 38增至 77 6 8;对照组由 5 2 8增至 72 8。冲击组、分次组及对照组梗塞灶形成率分别为 34 0 9%、46 43 %、72 0 %。冲击组、分次组对凝血及纤溶指标均有影响 ,以冲击组更明显。结论 :大剂量尿激酶冲击治疗急性脑梗塞在提高疗效、减少梗塞灶的发生率及缩小梗塞体积等方面均优于另二组。TT、FIB和D二聚体可作为溶栓监测的敏感指标更多还原

【Abstract】 Objective: To evaluate the therapeutic effect of thrombolysis in the acute cerebral infarction with various usages of Urokinase and to study the dynamic changes of the index of blood coagulation system and fibrinolysis system.Methods: 97 patients(the time internal from onset of stroke to the beginning of thrombolysis <6 hours) were divided into three groups:large dose stroke group(44 samples),small dose division group(28 samples) and control group(25 samples).Take down the ESS,TT,PT,APTT,FIB,D D,GMP 140 and FDP dynamically before and after the thrombolytic therapy.Results: one month after thrombolytic therapy,the ESS of large dose group increased from 51.81 to 90.89;the division group increased from 53.38 to 77.68;the control group from 52.8 to 72.8.The formation rates of cerebral infarction of stroke,division,control groups were 34.09%,46.43%,72.0% respectively.Both the stroke group and the division group influenced the index of blood coagulation system and fibrinolysis system;however,the strokde group influenced more obviously.Conclusion: The large dose Urokinase stroke thrombolytic therapy of acute cerebral infarction is better than the other two groups in improving the clinical effect,in decreasing the formation rate of infarction focus and in contracting the volume of infarction focus.TT,FIB and D D can be used as an acute index of monitoring thrombolysis.更多还原