【摘要】 目的:探讨大剂量尿激酶静脉溶栓治疗发病12小时内急性脑梗死的疗效和安全性。方法:符合入选标准的患者接受尿激酶100万u或150万u溶于生理盐水100～200 ml中,30分钟内滴完。随后静滴低分子葡聚精500 mlqd×10天。结果:接受尿激酶100万u静脉溶栓22例(A组),接受150万u25例(B组),两组之间溶栓后各时间点的ESS积分和ESS相对增加值虽差异无显著性,但B组相对高于A组,溶后第90天Barthel指数≥95分(完全和基本完全恢复)A组9例(40.9 ％)B组13例(52％)。症状性脑出血和全身出血B组高于A组,死亡每组各2例。结论:大剂量尿激酶静脉溶栓治疗发病12小时内急性脑梗死的疗效较高,相对安全,剂量越大,疗效相对较好,但出血的危险性也随之增加。更多还原

【Abstract】 Objective: To evaluate the efficacy and safety of a large dosage urokinase(UK) in the treatment of acute cerebral infarctions 12 h from onset. Methods: Patients consistent with the inclusion criteria received UK 1.0 or 1.5 MU in normal saline(NS) 100-200 ml intravenously over 30 min. Then 500 ml of low molecular dextran was infused intravenously per day for 10 days. Results: 22 patients received UK 1.0 MU(group A), 25 patients were given UK 1.5 MU(group B) intravenously. There were no remarkable differences between the two groups both in the ESS scores and in the increased ESS scores at different time after thrombolysis; but the ESS scores and the increased ESS scores of group B were slightly higher than that of group A. There were 9 cases(40.9%) in group A; 13 cases(52%) in group B of the Barthel indexes≥95 points(full recovery and almost full recovery). The incidence of symptomatic hemorrhage and systemic hemorrhage was higher in group B than that in group B, there were 2 patients died in every group respectively. Conclusion: A large dosage UK intravenous thrombolysis is effective and relatively safe in treatment of acute cerebral infarctions within 12 h, the larger the dosage, the relatively better the effect, however, the higher the incidence of hemorrhage.更多还原