摘要
目的研究重组组织型纤溶酶原激活剂(rt-PA)联合尤瑞克林拓展时间窗(4.5～9 h)溶栓治疗急性脑梗死的临床疗效。方法将90例急性脑梗死患者分为常规治疗组(A组)、rt-PA溶栓组(B组)、rt-PA联合尤瑞克林组(C组),各组按静脉干预时间再分为<4.5 h及4.5～9 h两亚组(n=15)。A组:常规治疗;B组:rt-PA静脉溶栓和常规治疗;C组:rt-PA、尤瑞克林和常规治疗。治疗前行头CT和多模式MRI检查,治疗后24 h复查头CT,分别于治疗前后不同时间点采用NIHSS行神经功能缺损评分,记录不良事件。结果 B、C组两亚组NIHSS评分显著低于A组相应亚组;B、C组两亚组治疗后评分较治疗前显著下降;且B、C组<4.5 h亚组评分显著小于4.5～9 h亚组;C组4.5～9 h亚组溶栓后7d、21d评分明显低于B组4.5～9 h亚组。结论多模式MRI指导下rt-PA联合尤瑞克林拓展时间4.5～9 h溶栓治疗安全,疗效肯定,且优于rt-PA单独溶栓治疗。
Objective To investigate the efficacy and safety of expanding thrombolytic time window by recombinant tissue-type plasminogen activator（rt-PA） with human urinary kallikrein（HUK） for acute cerebral infarction.Methods Patients were divided into routing cure group（group A）,rt-PA group（group B） and HUK combined with rt-PA group（group C）.Each group was divided into two subgroups depending on the onset time.Group A with normal drugs;Group B intravenous injection of rt-PA and normal drugs;Group C,besides rt-PA,using HUK and normal drugs.Head CT/Multimode MR and NIHSS were assessed before and after treatment.Side effects were evaluated.Results The scales of subgroups of group B and C were lower than ones of group A;Within 4.5 h onset the scales of Group B and C were lower than ones within 4.5~9 h.Group C was lower than group B since the 7th day within 4.5~9 h.Conclusion Under the guidance of multi-modal MRI,Rt-PA combined with urinary kallidinogenase development 4.5 ~ 9 h thrombolytic therapy is safety,more effective and better than rt-PA thrombolytic therapy alone.
出处
《哈尔滨医科大学学报》
CAS
北大核心
2012年第2期150-152,156,共4页
Journal of Harbin Medical University
关键词
急性脑梗死
多模式MRI
溶栓时间窗
重组组织型纤溶酶原激活剂
尤瑞克林
acute cerebral infarction
multimode magnetic resonance imaging
thrombolytic time window
recombinant tissue-type plasminogen activator
human urinary kallikrein
