摘要：目的：观察小剂量尿激酶联合丹奥治疗急性进展型脑梗死的临床疗效及安全性。方法：将60例进展型脑梗死患者随机分为两组：治疗组30例给予小剂量尿激酶50万u静滴每日一次，连续3d，同时给予丹奥80mg静滴每日一次，连续14d；对照组给予常规治疗(维脑路通、川芎嗪、脉络宁)，每日一次，连续14d。于治疗前、治疗后3、7、14、28d对患者进行神经功能缺损程度评分并评价其临床疗效，同时监测治疗前后(14d)患者血液流变学及PT、APTT的变化，观察其并发症的发生。结果：①治疗组神经功能缺损程度在短期内明显改善，阻止了其病情的恶化，与对照组比较有高度显著性差异(P<0.01)；②治疗组全血粘度、血浆粘度和纤维蛋白原明显降低，与对照组相比有高度显著性差异(P<0.01)；PT和APTT较治疗前及与对照组比较明显延长，但在正常范围；③治疗组总有效率90%，明显优于对照组(56.7%)；④两组并发症无明显差异(P>0.05)。结论：小剂量尿激酶联合丹奥治疗急性进展型脑梗死安全有效、并发症少，值得临床推广应用。

    关键词：小剂量； 尿激酶； 丹奥； 进展型脑梗死 治疗

    Clinical Research of Low Dose of Urokinase Combined with Sodium Ozagre in the Treatment of Acute Progressive Cerebral Infarction

    XIANG Jian-ping, XUE Yan-zhong, ZHANG Li-juan, etal

    (Yishui Central Hospital , Shandong Linyi 276400, China)

    Abstract: Objective： To observe the efficacy and safety of low dose of urokinase combined with sodium ozagre in the treatment of acute progressive cerebral infarction . Method： 60 patients with acute progressive cerebral infarction were randomly divided into two groups: treated group(n=30) was given intravenous drip of low dose of urokinase 500,000 units once a day for 3days, at the same time sodium ozagre (80mg once a day) was given by intravenous drip for 14 days continually; control group (n=30) received routine treatment (Troxerutin, Ligustrazine and Mailuoning), once a day for 14 days continually.Curative effects were assessed by the degree of nervous functional defects before treatment and in the 3rd , 7th ,14th, 28th day after treatment, the parameter of blood rheology were measured in two groups simultaneously before and after treatment(14th day), the prothrombin time (PT) and active partial thromboplastime time (APTT) were detected as well, the complications of each group were observed.Result： ①The degree of nervous functional defects of the patients in the treated group were improved markedly in short period and deterioration was prevented, there was significant difference compared with the control group(P<0.01).②The whole blood viscosity, plasma viscosity and fibrinogen of the patients in the treated group significantly decreased, There was significant difference between the treated group and the control group (P<0.01), the PT and APTT were much longer after treatment than that before treatment, compared in two groups(P<0.01), but they were in the normal scope. ③ The total effective rate of the treatment group was 90%, it was obvious better than the control group(56.7%). ④No significant difference in the complications between two groups was observed. Conclusion： Low dose of Urokinase combined with sodium ozagre in the treatment of acute progressive cerebral infarction was safe and effective with less complications, and deserves wide spreeding clinical application. ......