The Effectiveness And Safety Of Urokinase And Alteplase In Treatment Of Acute Cerebral Infarction

Due to the rapid development of economy and the progress of science andtechnology, the improvement in people’s medical conditions and improvement of livingstandards, gradually entered the aging society in China. Cerebrovascular disease hasbecome middle aged and old people the high incidence of disease. Of acute ischemicstroke with high incidence and high morbidity, clinical symptom is critical forcharacteristic, has gradually become the high incidence of disease of the middle agedand old people, seriously affect the health of the elderly and the life, has brought socialand family burden of economy and spirit, thus caused wide attention of the medicalprofession. Based on most of the ischemic stroke was caused by blood clots in thearteries occlusion circulatory disturbance of the cerebral blood flow, thus recanalizationoccluded blood vessels, restore the cerebral blood flow perfusion, save ischemia halfdark band has become a primary goal, we are using to treat early ischemic stroke earlythrombolysis is probably the most effective and most promising method. At present, inview of the thrombolysis, we use the drugs mainly for urokinase and atenolol enzyme,the two thrombolytic drugs of choice, to improve the clinical symptoms, reduce thecerebral infarction area, reduce mortality has important significance.Objectives: The main purpose of this study was to investigate urokinase and alteplase intravenous thrombolysis enzyme efficacy and safety for the treatment of acute,ischemic cerebral infarction.Methods: Cases source selection in October2012to March2014in dalianmunicipal central hospital neurology clinic of atenolol general intravenous thrombolysisalteplase treatment of50cases of patients with acute ischemic stroke, with the sameperiod of urokinase intravenous thrombolytic therapy with the same conditions ofpatients50cases as control group. Conditions in accordance with the standards of thegroup, eligible patients signed written informed consent given into groups.Results: Thrombolysis24hours before and after thrombolysis, by comparing thetwo groups of patients with NIHSS score, there were no statistically significantdifference (P>0.05);7days and14days after thrombolysis, NIHSS score comparisonof two groups of patients are no statistically significant differences (P>0.05).30daysafter the onset to MRS score of two groups of patients, urokinase group of50cases ofneural function in patients with good prognosis35cases (70%) and poor prognosis of12cases (24%),3cases died (6%). At alteplase group of50cases of neural function inpatients with good prognosis34cases (68%) and prognosis of14cases (28%),2casesdied (4%), two set of neural functional prognosis in patients with comparativedifference was no statistically significant (u=370.0, P>0.05). Urokinase grouppatients died in3patients (6%), atenolol, alteplase group patients died in2cases (4%),there was no statistically significant difference comparing the fatality rate of two groupsof patients (x2=0.002, P>0.05). Urokinase group symptomatic cerebral hemorrhage in2cases (4%), alteplase group symptomatic cerebral hemorrhage in1patients (2%), twogroups of patients with cerebral hemorrhage rate there was no statistically significantdifference comparing (x2=0.135, P>0.05).Conclusion: By Conclusion: through the research data show that as long as strictcontrol patients with thrombolysis, indications and contraindications, complications ofpatients with thrombolysis time window, the same basic similar cases, intravenousthrombolysis in acute cerebral infarction choice at alteplase and urokinase for patients24hours a day,7days,14days, the rate of blood vessels and prognosis of30days, roughly the same for the morbidity, mortality, and in patients with cerebral hemorrhageoccurs also has no obvious difference. This means that, to improve the symptoms ofpatients with nerve function defect and drug safety, etc., selection of urokinase andalteplase is safe and effective. For now, only China and Japan really widely used inclinic urokinase. Because a five year research results in domestic promotion, a lot ofbasic level hospitals participated in the experiment, far reaching;2because the cost islow, some basic level hospitals still in use. Although international think urokinase andatenolol enzyme, is not very ideal thrombolytic drug treatment of acute cerebrovasculardisease, but it is more accord with the situation of China at present stage treatment.Because cost, degree of promotion, and other reasons, a lot of basic level hospitals foralteplase, o may not, therefore, reasonable using urokinase thrombolysis is the moreeffective treatments for basic level hospitals. Thus conclude that the conditional canchoose urokinase or atenolol enzyme’s case, as far as possible use evidence basedmedical evidence more fully alteplase, when there is no alteplase, urokinase is optional.In a word, no matter choose what kind of drugs, still need to monitor the prognosis ofpatients with at any time, for patients condition suddenly aggravate in the process ofdrug use, must be timely review of brain CT, timely understanding of intracranialhemorrhage or not and give the right treatment.