联合应用低分子右旋糖酐及尿激酶治疗小灶性脑梗死临床探究.docVIP

联合应用低分子右旋糖酐及尿激酶治疗小灶性脑梗死临床探究 　【关键词】 尿激酶；低分子右旋糖酐；脑梗死；血液流变学 The clinical study on combined applicantion of lower molecular dextran and urokinase in treatment of small local brain infarction 【Abstract】 Objective To discuss the clinical curative effect of the association application of Dextran-40 and urokinase in treatment small range brain infarction and cooperation of them. Method Random will select a patient to is divided into group of Dextran-40 adds Urokinasum and normal saline added Urokinasum, the influence which passes a treatment in front and back grade and curative effect of the nerve function to judge the changes of the blood rheology on analysis, and the experiment data all learned by statistics. Results This data result shows that the Dextran-40 adds Urokinasum to arouse curative effect obviously better than the group of Urokinasumalone,Be learned processing marked difference to show by statistics（Plt;0.05）. Each group index of blood rheology to learn be reduce, the Dextran-40 adds Urokinasum to arouse more obviously（Plt;0.01）.Particularly the fibrinogen quickly lower at first, and become with time negative related, the better than the group of Urokinasum（Plt;0.05）. Conclusion The Dextran-40 and Urokinasum of the association application in treatment small range brain infarction curative effect show marked, two of them have a certainly cooperative function. 【Key words】 urokinase；dextran-40; brain infarction;blood rheology 缺血性脑血管病的治疗至今仍然是医学界普遍关注的热点问题，然而，对于发病时间已经超过24h的脑梗死，尤其是小灶性、多发性腔隙性脑梗死，目前临床上尚缺乏统一的治疗方法。据文献报道，低分子右旋糖酐与尿激酶具有一定的协同作用。据此，笔者近两年来对联合应用低分子右旋糖酐和尿激酶治疗急性小灶性脑梗死的临床疗效以及二者的协同性进行了初步研究,现报道如下。 1 资料与方法 1.1 病例选择 选择标准：（1）年龄在55～75岁之间；（2）发病在24h之后急性脑梗死患者，按照全国第四届脑血管学术会议制订的标准［1］，并经CT证实为小灶性或多发腔隙性脑梗死，肢体瘫痪在Ⅲ级以下；（3）CT排除脑出血或出血性梗死；（4）无全身严重疾病；（5）无出血倾向、消化道溃疡，排除血液系统疾病；（6）无糖尿病病史。本组50例均符合上述标准，按入院顺序随机分成低分子右旋糖酐加尿激酶组和小剂量尿激酶组。2组间发病时间、年龄、伴发疾病、既往史、神经功能缺损程度差异无显著性（P＞0.05）。 1.2 治疗方法 二组分别应用低分子右旋糖酐500ml+尿激酶组20万u和生理盐水100ml+尿激酶20万u连续静滴1周， 治疗期间两组同时辅以脱水、抗高血压等常规治疗，避免使用其他溶栓、抗凝以及抗血小板药物。 1.3