低剂量rt-PA联合尿激酶静脉溶栓治疗后循环脑梗死

摘要

Objective To evaluate the effect of low dose rt-PA combined with urokinase on vertebrobasilar system cerebral infarction.Methods Totally 100 patients with vertebrobasilar system cerebral infarction,were randomly divided into combination group,rt-PA group,urokinase group and control group,25 cases in each group.The national institutes of health stroke scale(NIH-SS) score,activities of daily living(ADL) score,clinical efficacy,cerebral hemorrhage rate and re-infarction rate were compared between the two groups.Results After treatment,the NIHSS score of each group were significantly lower than before treatment (P＜0.05),and the NIHSS score of combination group,rt-PA group and urokinase group were significantly lower than control group(P ＜0.05),but were no statistical difference between combination group,rt-PA group and urokinase group(P ＞0.05).After treatment,the ADL score of each group were significantly higher than before treatment(P＜20.05),and the NIHSS score of combination group,rt-PA group and urokinase group were significantly higher than control group (P ＜ 0.05),but were no statistical difference between combination group,rt-PA group and urokinase group(P＞0.05).The clinical efficacy of combination group,rtPA group and urokinase group were significantly higher than control group(P＜0.05),but were no statistical difference between combination group,rt-PA group and urokinase group (P ＞ 0.05).The re-infarction rate between each group were no statistical difference(P ＞0.05).The cerebral hemorrhage rate of combination group significantly lower than rt-PA group and urokinase group(P＜0.05).Conclusion Low dose rt-PA combined with urokinase treat with vertebrobasilar system cerebral infarction is effective and safe,and can effectively reduce cerebral hemorrhage rate.%目的 探讨低剂量重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt-PA)联合尿激酶静脉溶栓治疗椎基底动脉系统脑梗死的疗效及安全性.方法 选取100例椎基底动脉系统脑梗死患者,随机分为联合组、rt-PA组、尿激酶组和对照组各25例.比较各组患者神经功能缺损量表(NI HSS)评分、日常生活能力量表(ADL)、临床疗效、脑出血发生率及再梗死率.结果 治疗后,各组NIHSS评分均较治疗前显著降低(P＜0.05),且联合组、rt-PA组及尿激酶组显著低于对照组(P＜0.05),但联合组、rt-PA组及尿激酶组间比较无显著差异(P＞0.05).与治疗前相比,各组治疗后ADL评分显著提高(P＜0.05),且联合组、rt-PA组及尿激酶组显著高于对照组(P＜0.05),但联合组、rt-PA组及尿激酶组间比较差异无统计学意义(P＞0.05).联合组、rt-PA组及尿激酶组有效率均显著高于对照组(P＜0.05),但联合组、rt-PA组及尿激酶组间比较差异无统计学意义(P ＞0.05).各组再发脑梗死率比较差异无统计学意义(P＞0.05),联合组脑出血发生率显著低于rt-PA组、尿激酶组(P＜0.05).结论 低剂量rt-PA联合尿激酶静脉溶栓治疗椎基底动脉系统脑梗死安全有效,并可有效降低脑出血发生率.