尿激酶静脉溶栓治疗急性椎基底动脉缺血性卒中的临床疗效分析  

Effects of intravenous thrombolysis with urokinase for treatment of acute cerebral infarction due to vertebrobasilar ischemia

作　　者：刘丽[1] 蔡艺灵[1] 杜娟[1] 吴樵[1] 李薇[1] 崔永强[1] 孔祥锴 胡志慧[1] 

机构地区：[1]解放军第三0六医院神经内科,北京100101

出　　处：《中华神经医学杂志》2008年第9期942-944,共3页Chinese Journal of Neuromedicine

基　　金：总后卫生部“十一五”计划国际合作课题（06H001）

摘　　要：目的 探讨尿激酶静脉溶栓治疗急性期椎基底动脉系统缺血性卒中的临床疗效。方法13例急性期椎基底动脉系统缺血性卒中患者经静脉输注尿激酶50～150万U，并进行溶栓前、溶栓后即刻、6h、24h、7d、14d的美国国立卫生研究院卒中量表（NIHSS）评分，3个月时进行MRS评分以评定预后。结果13例患者在溶栓前NIHSS评分平均为（17.46±6．19）分，溶栓后评分呈下降趋势，溶栓后即刻为（11．77±6．47）分，溶栓后6h为（10．31＋5．65）分，24h为（7.92±6．43）分，7d为（6、58＋5．41）分，14d为（6．50±5．56）分。溶栓后24h后的时间段N1HSS评分与溶栓前相比均明显减少，差异有统计学意义（P〈0．05）。13例中有3例死亡，2例预后不佳，8例预后良好。4例出现出血并发症．其中脑出血2例。结论尿激酶静脉溶栓治疗可有效改善急性期椎基底动脉系统缺血性脑卒中的临床症状和预后。Objective To evaluate the effect of intravenous thrombolysis with urokinase for treatment of acute cerebral infarction due to vertebrobasilar artery ischemia. Methods Thirteen patients with a clinical diagnosis of acute cerebral infarction arising from vertebrobasilar artery ischemia received thrombolytic therapy with urokinase （5×10^-1.5×10^6 U） infused intravenously within 1h. The NIH Stroke Scale （NIHSS） was used to evaluate the patients＇ neurological function before and at 0, 6, 24 h and at 7 and 14 days after the treatment. Modified Rankin Scale （MRS） was used for neurological assessment 3 months after the treatments. Results The mean NIHSS score of the patients was 17.46± 6.19 before treatment and rapidly decreased to 7.92±6.43 24 h after the thrombolytic therapy. Three months after the therapy, 8 patients had favorable clinical outcomes defined as capability of independent living （MRS score of 0-2）; 2 patients had a poor outcomes with assisted living, and 3 patients died. Bleeding occurred in 4 cases including 2 cerebral hemorrhage cases. Conclusion Favorable clinical outcome can be achieved with intravenous urokinase therapy in the majority of patients with acute cerebral infarction due to vertebrobasilar ischemia.

关 键 词：静脉溶栓 椎基底动脉系统 急性缺血性卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]