尿激酶溶栓治疗急性脑梗死后出血的临床效果及机制研究(1)
【摘要】 目的：探讨尿激酶溶栓治疗急性脑梗死后出血的临床效果和机制，旨在为今后的治疗提供借鉴和参考。方法：将2015年3月-2017年3月本院收治的130例急性脑梗死后出血患者按随机分配法分为对照组和观察组，各65例。两组均采取依达拉奉注射的常规药物治疗方式，观察组在常规治疗的基础上应用尿激酶溶栓治疗。评定两组的疗效(KPS)、并发症状况和神经功能缺损(NIHISS)状况。结果：对照组KPS有效率为69.2%，并發症发生率为67.7%，NHISS评分为(7.7±3.6)分，观察组分别为93.8%、21.5%、(5.5±3.0)分，观察组的疗效较对照组更好，并发症发生率低，神经功能恢复更好(P<0.05)。结论：尿激酶溶栓治疗的关键在于适度恢复缺血区的血流供应，减轻再灌注的损伤，应用尿激酶溶栓治疗急性脑梗死后出血具有疗效好、并发症少、神经功能恢复好的良好效果，值得广泛临床推广。
【关键词】 尿激酶溶栓； 急性脑梗死； 脑出血
Study on Clinical Effect and Mechanism of Urokinase Thrombolysis in the Treatment of Acute Hemorrhagic Cerebral Infarction/YU Wei-qing，HUANG Wei-guo.//Medical Innovation of China，2017，14(17)：056-059
【Abstract】 Objective：To investigate the clinical effect and mechanism of Urokinase thrombolysis in the treatment of acute cerebral infarction，and providing a reference for the future trantment.Method：A total of 130 cases of acute cerebral infarction in our hospital from March 2015 to March 2017 were divided into the control group and the observation group according to the random assignment method，65 cases in each group. Two groups were all treated with conventional therapy，but the observation group should apply Urokinase thrombolytic therapy.KPS efficacy，complication status and NIHISS score of two groups were compared.Result：The effective rate of KPS in the control group was 69.2%，the complication rate was 67.7%，NHISS score was (7.7±3.6)score，the observation group were 93.8%，21.5% and (5.5±3.0)score，the observation group compared to the control group had a better recovery of efficacy，a lower complication rate，and a better recovery of nerve function(P<0.05).Conclusion：The key of Urokinase thrombolytic therapy is to moderate the recovery of ischemic blood flow and reduce reperfusion injury.It has a terrific effect that Urokinase thrombolytic therapy is applied to the treatment of acute cerebral infarction after hemorrhage，it should be widely promoted.
【Key words】 Urokinase； Acute cerebral infarction； Cerebral hemorrhage
First-author’s address：The People’s Hospital of Yangdong District in Yangjiang City，Yangjiang 529500，China
doi：10.3969/j.issn.1674-4985.2017.17.014
急性脑梗死后出血又称出血性脑梗死，其发病较急，进展较快，是脑梗死的一种急性时期，50～60岁以上是高发人群，发生率为30%～40%，大约25%的患者在发病前有短暂性脑缺血的发作病史[1]。随着CT的应用普及以及溶栓和抗凝治疗的广泛应用，急性脑梗死后出血的报道逐渐增多，现已引起了临床上的高度重视。尿激酶主要是从人肾组织中培养或从健康人尿里分离出来的一种酶蛋白，经溶栓治疗可以溶解血凝块，使血肿不再压迫周围脑组织，可以预防血栓的形成，并且对新形成的溶栓效果好，见效快[2-4]。选择2015年
3月-2017年3月本院收治的130例急性脑梗死后出血患者展开尿激酶溶栓研究，结果显示尿激酶溶栓治疗的关键在于脑部缺血区的血液适度恢复，且尿激酶溶栓治疗相较于常规治疗在疗效、并发症状况和神经功能改善上具有更加良好的效果，现报告如下。, 百拇医药(余伟清 黄维国)
【关键词】 尿激酶溶栓； 急性脑梗死； 脑出血
Study on Clinical Effect and Mechanism of Urokinase Thrombolysis in the Treatment of Acute Hemorrhagic Cerebral Infarction/YU Wei-qing，HUANG Wei-guo.//Medical Innovation of China，2017，14(17)：056-059
【Abstract】 Objective：To investigate the clinical effect and mechanism of Urokinase thrombolysis in the treatment of acute cerebral infarction，and providing a reference for the future trantment.Method：A total of 130 cases of acute cerebral infarction in our hospital from March 2015 to March 2017 were divided into the control group and the observation group according to the random assignment method，65 cases in each group. Two groups were all treated with conventional therapy，but the observation group should apply Urokinase thrombolytic therapy.KPS efficacy，complication status and NIHISS score of two groups were compared.Result：The effective rate of KPS in the control group was 69.2%，the complication rate was 67.7%，NHISS score was (7.7±3.6)score，the observation group were 93.8%，21.5% and (5.5±3.0)score，the observation group compared to the control group had a better recovery of efficacy，a lower complication rate，and a better recovery of nerve function(P<0.05).Conclusion：The key of Urokinase thrombolytic therapy is to moderate the recovery of ischemic blood flow and reduce reperfusion injury.It has a terrific effect that Urokinase thrombolytic therapy is applied to the treatment of acute cerebral infarction after hemorrhage，it should be widely promoted.
【Key words】 Urokinase； Acute cerebral infarction； Cerebral hemorrhage
First-author’s address：The People’s Hospital of Yangdong District in Yangjiang City，Yangjiang 529500，China
doi：10.3969/j.issn.1674-4985.2017.17.014
急性脑梗死后出血又称出血性脑梗死，其发病较急，进展较快，是脑梗死的一种急性时期，50～60岁以上是高发人群，发生率为30%～40%，大约25%的患者在发病前有短暂性脑缺血的发作病史[1]。随着CT的应用普及以及溶栓和抗凝治疗的广泛应用，急性脑梗死后出血的报道逐渐增多，现已引起了临床上的高度重视。尿激酶主要是从人肾组织中培养或从健康人尿里分离出来的一种酶蛋白，经溶栓治疗可以溶解血凝块，使血肿不再压迫周围脑组织，可以预防血栓的形成，并且对新形成的溶栓效果好，见效快[2-4]。选择2015年
3月-2017年3月本院收治的130例急性脑梗死后出血患者展开尿激酶溶栓研究，结果显示尿激酶溶栓治疗的关键在于脑部缺血区的血液适度恢复，且尿激酶溶栓治疗相较于常规治疗在疗效、并发症状况和神经功能改善上具有更加良好的效果，现报告如下。, 百拇医药(余伟清 黄维国)