Background and Purpose -To evaluate preliminarily efficacy and safety of intravenous tirofiban combined with mechanical clot disruption and urokinase in patients with stroke attributable to major cerebral artery occlu...Background and Purpose -To evaluate preliminarily efficacy and safety of intravenous tirofiban combined with mechanical clot disruption and urokinase in patients with stroke attributable to major cerebral artery occlusion. Methods -Eleven consecutive patients with stroke attributable to acute occlusion of a major cerebral artery were treated with an intravenous bolus injection of the platelet glycoprotein IIb/IIIa antagonist tirofiban combined with heparin and by endovascular procedures including mechanical thrombolysis and locally delivered urokinas e. Of the 11 cases, 9 involved angioplasty and 2 only microcatheter and microgui dewire manipulation. Results -There were 7 patients with internal carotid or mi ddle cerebral artery occlusion treated within 6 hours and 4 patients with basila r artery occlusion treated within 12 hours of symptom onset. Median National Ins titutes of Health Stroke Scale (NIHSS)score on admission was 20. After the inter ventional procedure, vessel recanalization was partial (thrombolysis in myocardi al infarction grade flow 2 [TIMI 2]) in 7 patients and absent or insufficient in 4 patients. Twenty-four hours after the procedure, all the patients but 1 impr oved substantially, and on control angiography, the occluded vessel was totally patent (TIMI 3) in 10 of the 11 patients. One patient with partial recanalizatio n did not improve and died 3 months later from pulmonary embolism. Neither a sym ptomatic intracerebral hemorrhage nor systemic bleedings requiring blood transfu sion occurred in any patient. At discharge, median NIHSS score was 2. The 3month outcome was excellent in 8 patients (modified Rankin Scale [mRS] 0 to 1), good in 2 patients (mRS 2), and poor in 1 patient (mRS 6). Conclusions -The combinat ion of intravenous tirofiban with intra-arterial mechanical clot disruption and urokinase may be successful in reopening an occluded major cerebral vessel with out increasing the hemorrhagic risk and with good functional outcome. This strat egy cannot be recommended as the systemati展开更多
目的探讨丹参川芎嗪注射液联合注射用尿激酶治疗急性心肌梗死的临床疗效。方法选择2016年6月—2017年7月在宣城市中心医院治疗的急性心肌梗死患者65例为研究对象,按照患者所用治疗方案差异将所有患者分为对照组(33例)和治疗组(32例)。...目的探讨丹参川芎嗪注射液联合注射用尿激酶治疗急性心肌梗死的临床疗效。方法选择2016年6月—2017年7月在宣城市中心医院治疗的急性心肌梗死患者65例为研究对象,按照患者所用治疗方案差异将所有患者分为对照组(33例)和治疗组(32例)。对照组给予注射用尿激酶,先静脉推注,50万单位加入到5%葡萄糖溶液20 m L中,而后更改为静脉滴注,50万单位加入到5%葡萄糖液500 m L中,1次/d。治疗组在对照组的基础上静脉滴注丹参川芎嗪注射液,10 m L加入到生理盐水500 m L中,1次/d。两组患者均连续治疗14 d。观察两组的临床疗效,比较两组的心功能指标和血管再通情况。结果治疗后,对照组和治疗组的总有效率分别为75.76%、87.50%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组左室射血分数(LVEF)、每搏心输出量(SV)均明显升高,中心静脉压(CVP)明显降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组和治疗组的血管再通率分别为57.58%、84.38%,两组比较差异具有统计学意义(P<0.05)。结论丹参川芎嗪注射液联合注射用尿激酶治疗急性心肌梗死具有较好的临床疗效,可改善心脏功能,提高血管再通率,具有一定的临床推广应用价值。展开更多
目的探讨七叶皂苷钠联合尿激酶和地塞米松治疗结核性脑膜炎的临床疗效。方法选取2011年4月—2014年4月在河北省胸科医院接受治疗的结核性脑膜炎患者76例,随机分为对照组和治疗组,每组各38例。对照组向髓鞘内注射地塞米松磷酸钠注射液,2....目的探讨七叶皂苷钠联合尿激酶和地塞米松治疗结核性脑膜炎的临床疗效。方法选取2011年4月—2014年4月在河北省胸科医院接受治疗的结核性脑膜炎患者76例,随机分为对照组和治疗组,每组各38例。对照组向髓鞘内注射地塞米松磷酸钠注射液,2.5 mg/次,前4周:2次/周,然后1次/周;并髓鞘内注入注射用尿激酶,10万单位/次,1次/d。治疗组在对照组基础上静脉输注注射用七叶皂苷钠,20 mg加入到5%葡萄糖溶液250 m L,1次/d。两组患者均治疗8周。观察两组的临床疗效,比较两组脑脊液中细胞数、蛋白质、葡萄糖、氯化物和颅内压的变化。结果治疗后,对照组和治疗组的总有效率分别为78.95%、94.74%,两组比较差异有统计学意义(P<0.05)。治疗后,两组脑脊液中细胞数、蛋白质和颅内压均显著下降,而葡萄糖和氯化物水平均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论七叶皂苷钠联合尿激酶和地塞米松治疗结核性脑膜炎具有较好的临床疗效,可明显改善脑脊液中各项指标,具有一定临床推广应用价值。展开更多
目的探讨醒脑静注射液联合注射用尿激酶治疗高血压脑出血的临床疗效。方法选取2015年1月—2016年6月武警后勤学院附属医院收治的高血压脑出血患者84例为研究对象,采用Excel表法随机分为对照组和治疗组,每组各42例。两组采用微创引流穿刺...目的探讨醒脑静注射液联合注射用尿激酶治疗高血压脑出血的临床疗效。方法选取2015年1月—2016年6月武警后勤学院附属医院收治的高血压脑出血患者84例为研究对象,采用Excel表法随机分为对照组和治疗组,每组各42例。两组采用微创引流穿刺术,向血肿腔内注入注射用尿激酶,10万单位加入到生理盐水5 m L中,保留2~3 h后引流。待血肿清除后拔管(5 d左右)。术后对照组静脉滴注5%葡萄糖注射液250 m L,1次/d;治疗组在对照组的基础上术后静脉滴注醒脑静注射液,20 m L加入到生理盐水250 m L中,1次/d。两组患者均持续治疗4周。观察两组的临床疗效,比较两组的美国国立卫生研究院脑卒中量表(NIHSS)评分和血清学指标。结果治疗后,对照组和治疗组的总有效率分别为81.0%、92.9%,两组比较差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组NIHSS评分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和巨噬细胞转移抑制因子(MIF)水平均显著下降,胰岛素样生长因子-1(IGF-1)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些血清学指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论醒脑静注射液联合注射用尿激酶治疗高血压脑出血具有较好的疗效,能改善神经功能,降低血清炎症水平,具有一定的临床推广应用价值。展开更多
文摘Background and Purpose -To evaluate preliminarily efficacy and safety of intravenous tirofiban combined with mechanical clot disruption and urokinase in patients with stroke attributable to major cerebral artery occlusion. Methods -Eleven consecutive patients with stroke attributable to acute occlusion of a major cerebral artery were treated with an intravenous bolus injection of the platelet glycoprotein IIb/IIIa antagonist tirofiban combined with heparin and by endovascular procedures including mechanical thrombolysis and locally delivered urokinas e. Of the 11 cases, 9 involved angioplasty and 2 only microcatheter and microgui dewire manipulation. Results -There were 7 patients with internal carotid or mi ddle cerebral artery occlusion treated within 6 hours and 4 patients with basila r artery occlusion treated within 12 hours of symptom onset. Median National Ins titutes of Health Stroke Scale (NIHSS)score on admission was 20. After the inter ventional procedure, vessel recanalization was partial (thrombolysis in myocardi al infarction grade flow 2 [TIMI 2]) in 7 patients and absent or insufficient in 4 patients. Twenty-four hours after the procedure, all the patients but 1 impr oved substantially, and on control angiography, the occluded vessel was totally patent (TIMI 3) in 10 of the 11 patients. One patient with partial recanalizatio n did not improve and died 3 months later from pulmonary embolism. Neither a sym ptomatic intracerebral hemorrhage nor systemic bleedings requiring blood transfu sion occurred in any patient. At discharge, median NIHSS score was 2. The 3month outcome was excellent in 8 patients (modified Rankin Scale [mRS] 0 to 1), good in 2 patients (mRS 2), and poor in 1 patient (mRS 6). Conclusions -The combinat ion of intravenous tirofiban with intra-arterial mechanical clot disruption and urokinase may be successful in reopening an occluded major cerebral vessel with out increasing the hemorrhagic risk and with good functional outcome. This strat egy cannot be recommended as the systemati
文摘目的探讨丹参川芎嗪注射液联合注射用尿激酶治疗急性心肌梗死的临床疗效。方法选择2016年6月—2017年7月在宣城市中心医院治疗的急性心肌梗死患者65例为研究对象,按照患者所用治疗方案差异将所有患者分为对照组(33例)和治疗组(32例)。对照组给予注射用尿激酶,先静脉推注,50万单位加入到5%葡萄糖溶液20 m L中,而后更改为静脉滴注,50万单位加入到5%葡萄糖液500 m L中,1次/d。治疗组在对照组的基础上静脉滴注丹参川芎嗪注射液,10 m L加入到生理盐水500 m L中,1次/d。两组患者均连续治疗14 d。观察两组的临床疗效,比较两组的心功能指标和血管再通情况。结果治疗后,对照组和治疗组的总有效率分别为75.76%、87.50%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组左室射血分数(LVEF)、每搏心输出量(SV)均明显升高,中心静脉压(CVP)明显降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组和治疗组的血管再通率分别为57.58%、84.38%,两组比较差异具有统计学意义(P<0.05)。结论丹参川芎嗪注射液联合注射用尿激酶治疗急性心肌梗死具有较好的临床疗效,可改善心脏功能,提高血管再通率,具有一定的临床推广应用价值。
文摘目的探讨七叶皂苷钠联合尿激酶和地塞米松治疗结核性脑膜炎的临床疗效。方法选取2011年4月—2014年4月在河北省胸科医院接受治疗的结核性脑膜炎患者76例,随机分为对照组和治疗组,每组各38例。对照组向髓鞘内注射地塞米松磷酸钠注射液,2.5 mg/次,前4周:2次/周,然后1次/周;并髓鞘内注入注射用尿激酶,10万单位/次,1次/d。治疗组在对照组基础上静脉输注注射用七叶皂苷钠,20 mg加入到5%葡萄糖溶液250 m L,1次/d。两组患者均治疗8周。观察两组的临床疗效,比较两组脑脊液中细胞数、蛋白质、葡萄糖、氯化物和颅内压的变化。结果治疗后,对照组和治疗组的总有效率分别为78.95%、94.74%,两组比较差异有统计学意义(P<0.05)。治疗后,两组脑脊液中细胞数、蛋白质和颅内压均显著下降,而葡萄糖和氯化物水平均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论七叶皂苷钠联合尿激酶和地塞米松治疗结核性脑膜炎具有较好的临床疗效,可明显改善脑脊液中各项指标,具有一定临床推广应用价值。
文摘目的探讨醒脑静注射液联合注射用尿激酶治疗高血压脑出血的临床疗效。方法选取2015年1月—2016年6月武警后勤学院附属医院收治的高血压脑出血患者84例为研究对象,采用Excel表法随机分为对照组和治疗组,每组各42例。两组采用微创引流穿刺术,向血肿腔内注入注射用尿激酶,10万单位加入到生理盐水5 m L中,保留2~3 h后引流。待血肿清除后拔管(5 d左右)。术后对照组静脉滴注5%葡萄糖注射液250 m L,1次/d;治疗组在对照组的基础上术后静脉滴注醒脑静注射液,20 m L加入到生理盐水250 m L中,1次/d。两组患者均持续治疗4周。观察两组的临床疗效,比较两组的美国国立卫生研究院脑卒中量表(NIHSS)评分和血清学指标。结果治疗后,对照组和治疗组的总有效率分别为81.0%、92.9%,两组比较差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组NIHSS评分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和巨噬细胞转移抑制因子(MIF)水平均显著下降,胰岛素样生长因子-1(IGF-1)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些血清学指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论醒脑静注射液联合注射用尿激酶治疗高血压脑出血具有较好的疗效,能改善神经功能,降低血清炎症水平,具有一定的临床推广应用价值。
