阿替普酶与尿激酶静脉溶栓治疗前循环脑梗塞的效果比较  

Comparison of the effect of intravenous thrombolysis with ateplase and urokinase in the treatment of anterior circulation cerebral infarction

作　　者：陈峥[1] 罗国刚[2] 王康军[1] 贺峰 张森岭 李剑 王舰[1] 魏莹[3] CHEN Zheng;LUO Guo-gang;WANG Kang-jun;HE Feng;ZHANG Sen-ling;LI Jian;WANG Jian;WEI Ying(Neurology Department, Hanzhong Center Hospital, Hanzhong 723000;Neurology Department, the First Affiliated Hosipital ofXi'an Jiaotong Univercity, Xi'an 710000;Clinical Pharmacy Department, Hanzhong Center Hospital, Hanzhong 723000, China)

机构地区：[1]汉中市中心医院神经内科,陕西汉中723000 [2]西安交通大学医学院第一附属医院神经内科,陕西西安710000 [3]汉中市中心医院临床药学科,陕西汉中723000

出　　处：《临床医学研究与实践》2019年第16期10-12,15,共4页Clinical Research and Practice

基　　金：陕西省科技统筹创新工程计划课题(No.2013BKTZB03-02-02);陕西省汉中市中心医院青年科研基金(No.YK1702)

摘　　要：目的比较阿替普酶与尿激酶静脉溶栓治疗前循环脑梗塞的效果。方法选择2014年1月至2017年9月在陕西省汉中市中心医院神经内科就诊的56例前循环脑梗塞患者为研究对象,根据患者的发病时间将其分为阿替普酶组(发病4.5h内,给予阿替普酶静脉溶栓治疗)和尿激酶组(发病6.0h内,给予尿激酶静脉溶栓治疗),各28例。比较两组患者溶栓后2、24h及7、90d的临床疗效、mRS评分及不良反应发生情况。结果阿替普酶组患者溶栓后2h及7、90d的疗效优于尿激酶组(P<0.05);两组溶栓后24h疗效比较,差异无统计学意义(P>0.05);阿替普酶组患者溶栓后90d预后显著优于尿激酶组(P<0.05);两组患者死亡率、症状性颅内出血、口腔、牙龈、皮肤黏膜出血及溶栓后再梗塞率比较,差异无统计学意义(P>0.05)。结论阿替普酶治疗前循环脑梗塞患者的疗效优于尿激酶,值得临床推广应用。Objective To compare the effect of intravenous thrombolysis with ateplase and urokinase in the treatment of anterior circulation cerebral infarction. Methods Fifty-six patients with anterior circulation cerebral infarction from January 2014 to September 2017 treated in the neurclogy department of Hanzhong central hospital were selected as the study objects. According to the time of onset, the patients were divided into ateplase group (within 4.5 hours of onset, intravenous thrombolytic therapy with ateplase) and urokinase group (within 6.0 hours of onset, intravenous thrombolytic therapy with urokinase), with 28 cases in each group. The clinical efficacy at 2, 24 hours and 7, 90 days after thrombolysis, mRS and adverse reactions were compared between the two groups. Results The effects of ateplase group after 2 hours, 7 and 90 days of thrombolysis were better than those in the urokinase group (P<0.05). There was no significant difference in effect between the two groups after 24 hours of thrombolysis (P>0.05). After 90 days of thrombolysis, the prognosis of patients in the ateplase group was significantly better than that of the urokinase group (P<0.05). There were no significant differences in mortality, symptomatic intracranial hemorrhage, oral cavity, gingiva, skin and mucosal hemorrhage and re-infarction rate after thrombolysis between the two groups (P>0.05). Conclusion Arteplase has better effect than urokinase in the treatment of anterior circulation cerebral infarction, which is worthy of clinical promotion and application.

关 键 词：阿替普酶 尿激酶 前循环脑梗塞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]