[Clinical study on ultra-early intravenous thrombolysis with high-dose urokinase in treatment of acute cerebral infarction]

Abstract

Objective: To determine the clinical curative effect and safety of ultra-early intravenous thrombolysis with high-dose urokinase in treatment of acute cerebral infarction.

Methods: Thirty-one patients with atherosclerotic cerebral infarction were treated with a single dose of 1.5 x 10(4) U/kg urokinase as intravenous thrombolytic therapy within 6 h after the onset. The decrease degree of nerve function defect integral, the cure rate, the effectual rate, and the total effective rate were observed 3 h and 21 days after thrombolysis, respectively, and the results were compared with those of conventional treatment. The infarct volume of patients treated with the two therapies were compared 21 days after treatment.

Results: The nerve function defect integral examined 3 h after thrombolysis (14.2 +/- 2.1) was markedly lower than that before thrombolysis (26.5 +/- 9.1). A remarkable difference (n = 31, t = 4.669, P < 0.05) was noticed between them. The cure rate and effectual rate reached 22.58% (7/31) and 67.74% (21/31), respectively. The decrease degree of nerve function defect integral, the cure rate, the effectual rate and the total effective rate evaluated 21 days after thrombolysis were all higher than those of conventional therapy group (from 26.5 +/- 9.1 to 8.8 +/- 2.8 vs from 26.4 +/- 8.1 to 16.3 +/- 4.1, t = 2.417; 51.61% vs 15. 38%, chi(2) = 5.037; 70.96% vs 42.30%, chi(2) = 4.765; 87.09% vs 65.38%, chi(2) = 3.886, respectively; all P < 0.05). The infarct volume was markedly smaller than that of the conventional therapy group (3.7 cm 3 +/- 3.0 cm(3) vs 5.3 cm(3) +/- 3.1 cm(3), t = 2.165, P < 0.05).

Conclusion: Ultra-early intravenous thrombolysis with a single dose of 1.5x10(4) U/kg urokinase in the treatment of atherosclerotic cerebral infarction has a better clinical curative effect and less complication, and it can also have the infarct volume markedly reduced.