尿激酶超选择性动脉内溶栓后应用尤瑞克林对急性后循环脑梗死脑血流动力学的影响  

Efficacy and safety of arterial thrombolysis combined with urinary kallidinogenase on cerebral bemodynamics and the prognosis of patients with acute collateral circulation cerebral infarction

作　　者：王占强[1] 徐莉[2] 周利[3] 鲁慧[1] 崔宁宁[1] 李猛[1] 邵汝升[1] 

机构地区：[1]河北省沧州市中心医院神经内五科,061000 [2]河北省沧州市中心医院神经电生理科,061000 [3]河北省沧州市中心医院超声三科,061000

出　　处：《疑难病杂志》2016年第3期236-240,F0003,共6页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察尿激酶超选择性动脉内溶栓后应用尤瑞克林治疗椎一基底动脉闭塞致急性脑梗死的效果。方法选取2013年5月—2014年8月沧州市中心医院神经内五科诊治的急性脑梗死患者60例,按随机数字表法随机分为2组,治疗组30例采用尿激酶溶栓与尤瑞克林组合治疗,对照组30例患者采用单纯给予动脉溶栓治疗,观察分析2组患者用药后的疗效,随访4周,计算NIHSS评分、ADL评分,评价用药安全性。结果治疗组临床疗效明显优于对照组(86.7%vs.70.0%,x^2=5.956,P<0.05);治疗后,治疗组NIH-SS评分下降程度明显优于对照组,ADL评分升高程度均明显优于对照组(P<0.05);治疗后,治疗组脑血管平均血流速度(V)、平均血流量(Q)均明显大于对照组(P<0.05),血管特性阻抗(Zc)及血管外周阻力(R)均明显低于对照组(P<0.05);治疗组两侧椎动脉及基底动脉血管彩超表现也明显优于对照组(P<0.05)。2组用药安全性比较差异无统计学意义(P>0.05)。结论尿激酶溶栓加尤瑞克林治疗急性脑梗死效果明显,能显著减轻脑缺血后的炎性反应、可推广应用。Objective To explore the effect of arterial thrombolysis combined with urinary kallidinogenase on the prognosis of patients with acute collateral circulation cerebral infarction.Methods Selected 60 cases of acute cerebral infarction patients from 2013 May to 2014 August at Cangzhou Central Hospital,according to the random number table method.they were randomly divided into two groups,30 cases in the treatment group were treated with urokinase and urinan kallidinogenase,control group（30 cases） were treated with arterial thrombolytic therapy,after treatment,curative effect were observed and analvzed in the two groups,patients were followed up for 4 weeks,NIHSS and ADL scores were calculated,and drug safety was assessed.Results In the treatment group,the clinical curative effect was significantly better than the control group（86.7%vs.70.0%,t =5.956,P〈0.05）,after treatment,NIHSS score in the treatment group decreased significantly than the control group,ADL scores improvement was significantly better than the control group（P〈0.05）;2 group＇s drug safety differences had no statistical significance（P〉0.05）,treatment group＇ s cerebral blood vessel mean blood flow velocity（V）,the average blood flow（Q） were significantly higher than those in control group（P〈0.05）,vascular characteristic impedance（ZC） and vascular peripheral resistance（R） were significantly lower than control group（P〈0.05）.The treatment group＇s both sides of vertebral artery and basilar artery vascular ultrasound results also significantly better than the control group（P〈0.05）.Conclusion The effect of urokinase thrombolytic therapy combined with urinan kallidinogenase treatment for acute cerebral infarction is obvious,it can alleviate cerebral ischemia after the inflammatory reaction,and can be widely applied.

关 键 词：动脉内溶栓 尿激酶 尤瑞克林 椎—基底动脉闭塞 脑梗死 急性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]