重组人组织纤溶酶原激活物联合尿激酶治疗急性脑梗死效果分析.docVIP

重组人组织纤溶酶原激活物联合尿激酶治疗急性脑梗死效果分析 　　[摘要] 目的 探讨重组人组织纤溶酶原激活物（rtPA）联合尿激酶静脉溶栓治疗发病6 h内的急性脑梗死的有效性及安全性。 方法 回顾性收集本院2005年11月～2012年12月所有接受静脉溶栓治疗的患者，共纳入129例患者，根据用药史分为rtPA组（63例）及rtPA联合尿激酶组（66例），记录患者的一般临床资料及发病到用药时间；基线及用药7、30、90 d的美国国立卫生院卒中评分（NIHSS）、Barthel指数（BI）；溶栓后的出血率及死亡率。 结果 两组患者静脉溶栓后各随访时间点NIHSS及BI均较治疗前改善，差异有统计学意义（P0.05）。两组间在安全性和有效性上差异无统计学意义（P0.05）。 结论 发病6 h内无禁忌证的急性脑梗死患者rtPA联合尿激酶静脉溶栓的疗效和安全性与rtPA静脉溶栓无显著性差异。 　　[关键词] 急性脑梗死；静脉溶栓；重组人组织纤溶酶原激活物；尿激酶；时间窗 　　[中图分类号] R971 [文献标识码] A [文章编号] 1674-4721（2015）01（b）-0076-04 　　The effect of recombinant tissue plasminogen combined with urokinaseon in treatment of acute cerebral infarction 　　LI Ying CHEN Hui LIU Nan HUANG Yong-hua▲ 　　Department of Neurology，Military General Hospital of Beijing City，Beijing 100700，China 　　[Abstract] Objective To investigate the effect and safety of recombinant tissue plasminogen （rtPA） combined with urokinaseon in treatment of acute cerebral infarction. Methods 129 patients who received thrombolytic therapy in our hospital from November 2005 to December 2012 were selected，and were divided into rtPA group （63 cases） and rtPA combined with urokinaseon group （66 cases）.The demographic data，onset-to-needle time and baseline clinical characteristics （symptoms，medical history，blood pressure，blood glucose，blood lipids，National Institutes of Health Stroke Scale （NIHSS） score，Barthel index （BI） were recorded at baseline.The NIHSS and BI were recorded at 7 days，30 days and 90 days after thrombolysis.The mortality rate and theincidences of intracerebral and other hemorrhages were recorded. Results After intravenous thrombolysis each follow-up time point，NIHSS and BI of two groups was improved than that before treatment，the difference was significant （P0.05）.There was no significant difference on the safety and efficacy between the two groups （P0.05）. Conclusion For patients with acute cerebral infarction and no contraindications onset within 6 hours，the efficacy and safety of rtPA combined with urokinase is similar to urok