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目的 评价尿激酶 (UK)对急性脑梗死进行静脉溶栓的疗效及安全性。方法 本研究为开放性随机对照临床研究 ,入选患者随机分为两组 :UK组 (48例 )接受UK 5 0万～ 12 5万IU静脉滴注 ,随后静滴低分子右旋糖酐及口服阿司匹林。对照组 (96例 )则只接受低分子右旋糖酐及阿司匹林治疗。神经功能缺损评价采用欧洲卒中量表 (ESS)。结果 UK平均用量为 6 7 19万IU。溶栓后ESS分值增加迅速 ,两组间有显著性差异 ,治疗后 2 1d时 ,总有效率 ,UK组为89 5 7%,对照组为 72 92 %(P <0 0 5 ) ;脑出血发生率分别为 10 4 2 %与 8 33%(P >0 0 5 ) :病死率分别为 6 94%与 6 2 5 %(P >0 0 5 )。结论 提示尿激酶静脉溶栓治疗急性脑梗死是有效的 ,如严格掌握时间窗及适应症 ,该疗法相对比较安全。
Objective To evaluate the efficacy and safety of urokinase (UK) for intravenous thrombolysis in patients with acute cerebral infarction. METHODS: This open-label, randomized, controlled clinical study of patients enrolled in the study was randomly divided into two groups: UK (n = 48) receiving UK 50,000 to 125,000 IU iv drip followed by low molecular weight dextran and oral aspirin. Control group (96 cases) only received low molecular dextran and aspirin treatment. Neurological impairment was assessed using the European Stroke Scale (ESS). The average UK usage was 67.19 million IU. ESS scores increased rapidly after thrombolysis, with significant differences between the two groups. After 21 days of treatment, the total effective rate was 89.57% in the UK group and 72.92% in the control group (P <0.05). Brain Bleeding rates were 10 4 2% and 8 33%, respectively (P 0 05): the mortality rates were 694% and 62 5%, respectively (P 0 05). The conclusion suggests that intravenous thrombolytic therapy of urokinase is effective in acute cerebral infarction. If the time window and indications are strictly controlled, the therapy is relatively safe.