摘要
目的比较尿激酶和巴曲酶治疗超早期脑梗死的效果和安全性。方法比较150万单荆量尿激酶和不同剂量及给药时间的巴曲酶治疗发病6h内脑梗死的效果。以治疗后3个月和6个月死亡率、改良Rankin评分（mRS）和巴塞尔指数（BI）作为主要终结指标，以美国国家卫生研究所卒中评分（NIHSS）变化作为次要终结指标，收录患者74例。分为A组（尿激酶组）26例，B组（巴曲酶常规剂量组）25例，C组（巴曲酶加大剂量及延长疗程组）23例。结果尿激酶和巴曲酶均可以改善部分患者神经功能评分，2h内尿激酶平均改善NIHSS较快，但是有波动，而巴曲酶效果较平缓而稳定。3个月时A、B、C各组的BI95。100分患者占的比例分别是26．9％，33．3％，28．6％；mRS0～2分患者分别为42，3％，41，7％，42．9％；6个月BI95—100分患者占的比例分别是50．0％，58．3％，47．6％；mRS 0—2分患者分别为57．7％，66．7％，57．1％。差异均无显著性意义．结论缺血性脑卒中6h内给予尿激酶或者巴曲酶对3个月和6个月后终结指标影响没有显著差异。
Objectives To compare the efficacy and safety of thrombolysing and defibrating therapies in ischemic stroke patients within 6 hours of ictus. Methods Seventy-four patients suffering from ischemic stroke within 6 hours were divided into 3 groups：26 cases（Group A） received intravenous urokinase;25 cases（Group B） received batroxobin 10 U on day 1 and 5 U on days 3 and 5;23 cases（Group C） received batroxobin 10 U on days 1, 3 and 5, then 5 U on days 7 and 9. Primary endpoints were the death rate and modified Rankin Scale（mRS） ≤2 at the month 3 and the month 6. Barthel Index（BI） and NIHSS were used as secondary endpoints. Results Urokinase showed a faster effect in the first 6 hours, but the efficacy decreased from 12 hours to third day. Batroxobin showed slower but more stable effect. At 3 months of follow-up, the patients with BI of 95- 100 points in Group A, Group B and Group C accounted for 26.9%, 33.3%, and 28.6%, respectively, and patients with modified Rankin Scale ≤2 accounted for 42.3 % ,41.7 % and 42.9% respectively. On day 180, the patients with BI 95 - 100 points in the 3 groups accounted for 50.0%, 58.3 % and 47.6%, respectively and the patients with mRS 0 - 2 accounted for 57.7 %, 66.7 % and 57.1%, respectively. There was no statistically significant difference among the groups. Conclusion Urokinase or batroxobin used in acute stroke within 6 hour time window showed no significant difference in efficacy and safety on day 30 and day 180 of the follow-up.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2006年第2期104-107,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家科委十五攻关项目(2001BA703B11)
关键词
脑梗塞
尿纤溶酶原激活物
巴曲酶
血栓溶解疗法
brain infarction
urinary plasminogen activator
batroxobin
thrombolytic therapy
作者简介
黄一宁，男，1955年12月生，广西壮族自治区南宁市人，主任医师，教授。博士生导师，硕士，从事神经内科专业。
