CAJ | 학술논문

目的：比较重组组织型纤溶酶原激活剂（ rt－PA）与尿激酶治疗急性脑梗死的临床疗效和安全性，提高患者生活质量。方法：将58例患者分为观察组28例和对照组30例，均给予常规治疗，观察组采用rt－PA静脉溶栓，对照组采用尿激酶静脉溶栓，入院时及溶栓后24h、7d、14d采用美国国立卫生研究院卒中量表（ NIHSS）进行评分。结果：溶栓前两组患者NIHSS评分相似，差异无统计学意义（P＞0．05）；溶栓后，两组NIHSS评分较治疗前均下降，差异有统计学意义（P＜0．05），但观察组NIHSS评分较对照组下降幅度更大，差异有统计学意义（ P＜0．05）。观察组患者痊愈8例、显效14例、有效4例、无效1例和恶化1例，对照组痊愈4例、显效12例、有效9例、无效3例和恶化2例，观察组临床疗效优于对照组，差异有统计学意义（ P＜0．05）。观察组患者出血发生率14．29％，与对照组的20．00％相似，差异无统计学意义（ P＞0．05）。结论：rt－PA静脉溶栓治疗急性脑梗死的临床疗效优于尿激酶，但未增加出血风险。
목적：비교중조조직형섬용매원격활제（ rt－PA）여뇨격매치료급성뇌경사적림상료효화안전성，제고환자생활질량。방법：장58례환자분위관찰조28례화대조조30례，균급여상규치료，관찰조채용rt－PA정맥용전，대조조채용뇨격매정맥용전，입원시급용전후24h、7d、14d채용미국국립위생연구원졸중량표（ NIHSS）진행평분。결과：용전전량조환자NIHSS평분상사，차이무통계학의의（P＞0．05）；용전후，량조NIHSS평분교치료전균하강，차이유통계학의의（P＜0．05），단관찰조NIHSS평분교대조조하강폭도경대，차이유통계학의의（ P＜0．05）。관찰조환자전유8례、현효14례、유효4례、무효1례화악화1례，대조조전유4례、현효12례、유효9례、무효3례화악화2례，관찰조림상료효우우대조조，차이유통계학의의（ P＜0．05）。관찰조환자출혈발생솔14．29％，여대조조적20．00％상사，차이무통계학의의（ P＞0．05）。결론：rt－PA정맥용전치료급성뇌경사적림상료효우우뇨격매，단미증가출혈풍험。
Objective:To compare the safeties and clinical effect of recombinant tissue plasminogen ac-tivator (rt-PA) vs urokinase in treatment of acute cerebral infarction , and to elevate the quality of life of the patients.Methods:A total of 58 patients were divided into observation group and control group , with 28 pa-tients in the observation group and 30 patients in the control group .All the patients were given with conven-tional therapies, and the observation group used rt-PA for intravenous thrombolysis , while the control group used urokinase , and national institutes of health stroke scale ( NIHSS) scores were made on admission and at 24h, 7d, and 14d after thrombolysis, respectively.Result:Before thrombolysis, the two groups had similar NIHSS scores, and the difference was statistically insignificant (P>0.05); after thrombolysis, both groups had decreased NIHSS scores , and the differences were statistically significant ( P<0.05);but the observation group had significantly greater decreasing extents than the control group , and the differences were statistically significant ( P<0.05) .Of the observation group , 8 patients were cured , 14 cases were responsive to the ther-apy excellently , 4 cases were responsive to the therapy , 1 case was unresponsive to the therapy , and 1 case was aggravated;while of the control group , 4 patients were cured , 12 cases were responsive to the therapy excellently , 9 cases were responsive to the therapy , 3 cases were unresponsive to the therapy , and 2 cases were aggravated;and the differences were statistically significant ( P<0.05 ) .The hemorrhage incidence in the patients of the observation group was 14.29%, which was similar to that of the control group (20.00%), and the difference was statistically insignificant ( P>0.05 ) .Conclusion: Intravenous thrombolysis with rt-PA in treatment of acute cerebral infarction has better clinical therapeutic effects than urokinase , and does not increase hemorrhage risk .