重组组织型纤溶酶原激活剂与尿激酶静脉溶栓治疗急性脑梗死临床观察

摘要

目的：比较重组组织型纤溶酶原激活剂（ rt－PA）与尿激酶治疗急性脑梗死的临床疗效和安全性，提高患者生活质量。方法：将58例患者分为观察组28例和对照组30例，均给予常规治疗，观察组采用rt－PA静脉溶栓，对照组采用尿激酶静脉溶栓，入院时及溶栓后24h、7d、14d采用美国国立卫生研究院卒中量表（ NIHSS）进行评分。结果：溶栓前两组患者NIHSS评分相似，差异无统计学意义（P＞0．05）；溶栓后，两组NIHSS评分较治疗前均下降，差异有统计学意义（P＜0．05），但观察组NIHSS评分较对照组下降幅度更大，差异有统计学意义（ P＜0．05）。观察组患者痊愈8例、显效14例、有效4例、无效1例和恶化1例，对照组痊愈4例、显效12例、有效9例、无效3例和恶化2例，观察组临床疗效优于对照组，差异有统计学意义（ P＜0．05）。观察组患者出血发生率14．29％，与对照组的20．00％相似，差异无统计学意义（ P＞0．05）。结论：rt－PA静脉溶栓治疗急性脑梗死的临床疗效优于尿激酶，但未增加出血风险。%Objective:To compare the safeties and clinical effect of recombinant tissue plasminogen ac-tivator (rt-PA) vs urokinase in treatment of acute cerebral infarction , and to elevate the quality of life of the patients.Methods:A total of 58 patients were divided into observation group and control group , with 28 pa-tients in the observation group and 30 patients in the control group .All the patients were given with conven-tional therapies, and the observation group used rt-PA for intravenous thrombolysis , while the control group used urokinase , and national institutes of health stroke scale ( NIHSS) scores were made on admission and at 24h, 7d, and 14d after thrombolysis, respectively.Result:Before thrombolysis, the two groups had similar NIHSS scores, and the difference was statistically insignificant (P>0.05); after thrombolysis, both groups had decreased NIHSS scores , and the differences were statistically significant ( P<0.05);but the observation group had significantly greater decreasing extents than the control group , and the differences were statistically significant ( P<0.05) .Of the observation group , 8 patients were cured , 14 cases were responsive to the ther-apy excellently , 4 cases were responsive to the therapy , 1 case was unresponsive to the therapy , and 1 case was aggravated;while of the control group , 4 patients were cured , 12 cases were responsive to the therapy excellently , 9 cases were responsive to the therapy , 3 cases were unresponsive to the therapy , and 2 cases were aggravated;and the differences were statistically significant ( P<0.05 ) .The hemorrhage incidence in the patients of the observation group was 14.29%, which was similar to that of the control group (20.00%), and the difference was statistically insignificant ( P>0.05 ) .Conclusion: Intravenous thrombolysis with rt-PA in treatment of acute cerebral infarction has better clinical therapeutic effects than urokinase , and does not increase hemorrhage risk .