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目的探讨人尿激肽原酶(尤瑞克林)对促进急性期脑梗死病灶周围侧支循环建立的作用。方法收集2014年1月至2015年12月住院的62例急性期脑梗死患者[第1天行磁共振(MRI)脑灌注加权成像(MRI-PWI)均提示病灶灌注不足]的临床资料,根据是否使用尤瑞克林分为干预组(38例)和非干预组(24例),第1天和第10天分别行MRI-PWI观察病灶灌注变化情况,美国国立卫生研究院卒中量表(NIHSS)评分进行疗效判定,3个月后行改良Rankin量表(mRS)评分评估预后。结果尤瑞克林干预组显著有效率均优于非干预组(68.4%vs 37.5%,P<0.05),预后良好率优于非干预组(89.5%vs 50.0%,P<0.05)。尤瑞克林干预组有30例(78.9%)建立侧支循环,非干预组只有5例(20.8%)建立侧支循环,干预组灌注良好率优于非干预组(78.9%vs 20.8%,P<0.05)。治疗前后MRI-PWI各参数比较:尤瑞克林干预组局部脑血流量(rCBF)治疗前后差异有统计学意义(P<0.05),而局部脑血容量(rCBV)及平均通过时间(MTT)差异无统计学意义(P均>0.05)。非干预组rCBV、rCBF、MTT在治疗前后差异均无统计学意义(P均>0.05)。结论尤瑞克林有促进急性期脑梗死病灶周围侧支循环建立的作用,并可改善急性脑梗死患者的预后。
Objective To investigate the effect of human urokinase (Urelin) on the development of collateral circulation around the focal cerebral infarction in acute stage. Methods The clinical data of 62 patients with acute cerebral infarction who were hospitalized from January 2014 to December 2015 [MRI-PWI on the first day were all suggestive of insufficient perfusion of the lesion] were collected. According to the clinical data of The patients were divided into intervention group (n = 38) and non-intervention group (n = 24). MRI perfusion imaging was performed on the first day and the tenth day to observe the change of perfusion. The National Institutes of Health Stroke Scale NIHSS) score for efficacy evaluation, 3 months after the modified Rankin scale (mRS) score assessment of prognosis. Results The effective rate of the prednisone group was significantly higher than that of the non - intervention group (68.4% vs 37.5%, P <0.05). The good prognosis rate of the prednisone group was better than that of the non - intervention group (89.5% vs 50.0%, P <0.05). Collateral circulation was established in 30 patients (78.9%) in the uric acid intervention group and in 5 (20.8%) patients in the non-intervention group. The rate of perfusion in the intervention group was better than that in the non-intervention group (78.9% vs 20.8% P <0.05). The comparison of MRI-PWI parameters before and after treatment showed that there was significant difference between before and after local cerebral blood flow (rCBF) in patients with erectile dysfunction (rCBF) (P <0.05), while local cerebral blood volume (rCBV) and mean transit time (MTT) The difference was not statistically significant (P> 0.05). There was no significant difference in rCBV, rCBF and MTT between non-intervention group before and after treatment (all P> 0.05). Conclusion Youreklin can promote the establishment of collateral circulation around the acute cerebral infarction and improve the prognosis of patients with acute cerebral infarction.