CAJ | 학술논문

目的探讨静脉联合应用尿激酶和硫酸镁治疗急性脑梗死的疗效和最佳剂量.方法将100例急性脑梗死患者按照随机数字表法分为0 mL组(24例)、10 mL组(24例)、20 mL组(24例)和对照组(28例).0 mL组、10 mL组和20mL组患者即在静脉应用尿激酶溶栓的同时静脉泵入0 mL、10 mL、20 mL的硫酸镁,在之后的24 h静滴60 mL硫酸镁,然后每天20 mL静滴,硫酸镁维持治疗14d,对照组则不用硫酸镁.治疗期间监测患者的血压、腱反射,动态观察血清镁浓度,在治疗后30 d和90 d对所有患者进行欧洲卒中量表(ESS)评分.结果 10 mL、20 mL组患者治疗后血清镁浓度能够迅速提升,远期ESS评分较治疗前明显增加,其中20mL组更为有效.所有患者均没有观察到明显的不能耐受的不良反应.结论静脉联合应用溶栓剂尿激酶和硫酸镁(负荷应用10 mL、20 mL)对脑梗死患者具有良好的治疗作用,其中20 mL负荷量效果最佳.
목적 탐토정맥연합응용뇨격매화류산미치료급성뇌경사적료효화최가제량.방법 장100례급성뇌경사환자안조수궤수자표법분위0 mL조(24례)、10 mL조(24례)、20 mL조(24례)화대조조(28례).0 mL조、10 mL조화20mL조환자즉재정맥응용뇨격매용전적동시정맥빙입0 mL、10 mL、20 mL적류산미,재지후적24 h정적60 mL류산미,연후매천20 mL정적,류산미유지치료14d,대조조칙불용류산미.치료기간감측환자적혈압、건반사,동태관찰혈청미농도,재치료후30 d화90 d대소유환자진행구주졸중량표(ESS)평분.결과 10 mL、20 mL조환자치료후혈청미농도능구신속제승,원기ESS평분교치료전명현증가,기중20mL조경위유효.소유환자균몰유관찰도명현적불능내수적불량반응.결론 정맥연합응용용전제뇨격매화류산미(부하응용10 mL、20 mL)대뇌경사환자구유량호적치료작용,기중20 mL부하량효과최가.
Objective To evaluate the therapeutic effect of intravenous magnesium sulfate (MgSO4) infusion combined with urokinase (UK) and determine the optimal dose for treatment of acute cerebral infarction (ACI). Methods One hundred patients with AC1 were randomized into 0, 10, 20 mL group and control group (n=24, 24, 24, 28), and the former 3 groups received intravenous loading infusion of 0, 10, or 20 mL of 25% MgSO4 in addition to OK treatment. After the initial dose of MgSO4, the patients in the combined treatment group received intravenous infusion of 60 mL MgSO4 within 24 h, followed by a daily dose of 20 mL for 14 consecutive days. The blood pressure, tendon reflex, and serum magnesium concentration were monitored during the therapy, and European Stroke Scale (ESS) scores of the patients were recorded at 30 and 90 days after the therapy. Results Treatment with 10 and 20 mL 25% MgSO4 in combination with UK resulted in rapid elevation of serum magnesium concentration and an obvious increase in the long-term ESS score, and the effect was especially obvious with 20 mL MgSO4 No severe adverse effect was noted in these patients during the therapy. Conclusion UK combined with intravenous infusion of 10 or 20 mL 25% MgSO4 may produce obvious therapeutic effect in patients with ACI, and a loading dose of MgSO4 at 20 mL can be optimal.