急性缺血性卒中患者尿激酶动脉溶栓治疗的临床观察  

lntra-Arterial Thrombolysis with Urokinase in Patients with Acute lschemic Stroke： A Clinical Observation

作　　者：周俊山[1] 姜建东[1] 王景涛[1] 杨杰[1] 陈亮[2] 顾建平[2] 

机构地区：[1]南京医科大学附属南京第一医院神经内科,210006 [2]南京医科大学附属南京第一医院介入放射科,210006

出　　处：《国际脑血管病杂志》2008年第5期321-325,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的：评价尿激酶选择性动脉溶栓治疗急性脑梗死的疗效和安全性。方法：38例急性脑梗死患者在发病后6h内进行尿激酶选择性动脉溶栓治疗，术后即刻和24h分别行头颅CT检查了解有无颅内出血。采用Barthel指数（BI）和美国国立卫生研究院卒中量表（NIHSS）评分对患者6个月时的生活状态和功能转归进行评价。结果：38例患者中，21例完全再通，8例部分再通，3例发生有症状颅内出血，1例死亡。术后90d时，22例功能转归良好（BI≥90分），11例较好（50分≤BI〈90分），4例较差（BI〈50分）；术后6个月时，24例功能转归良好，9例较好，4例较差。术后14d时的NIHSS评分显著优于术前水平（12．68±7．43对15．38±4．32，P〈0．01）。结论：尿激酶动脉溶栓能使闭塞血管再通，改善患者急性期临床症状和远期预后。Objective： To evaluate the efficacy and safety of selective intra-arterial thrombolysis with urokinase for acute cerebral infarction.Methods： Thirty-eight patients with acute cerebral infarction were treated by selective intra-arterial thrombolysis with urokinase within 6 hours of onset. Head CT scans were performed immediately and 24 hours after the procedures to find out whether intracerebral hemorrhage （ICH） had occurred. The activities of daily living and functional outcome of the patients were evaluated by the Barthel Index （BI） and the National Institutes of Health Stroke Scale （NIHSS）. Results： Of the 38 patients, 21 achieved complete recanalization, 8 achieved partial recanalization, 3 occurred symptomatic intracranial hemorrhage, and 1 died. At day 90, 22 patients had a favorable outcome （BI≥90）, 11 （50 ≤BI 〈90） had a better outcome, and 4 had a worse one （BI 〈 50）; at 6 months, 24 patients had a favorable outcome, 9 had a better outcome, and 4 had a worse one. The NIHSS scores at day 14 after the procedures were significantly superior to the levels before the procedures （12.68±7.43 versus 15.38±4.32, P 〈0.01）. Conclusions： Intra-arterial thrombolysis with urokinase can recanalize the occluded vessels and improve the acute clinical symptoms and long-term prognosis of patients.

关 键 词：动脉溶栓 尿激酶 缺血性卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]