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目的:探讨小剂量尿激酶联合银杏叶提取物治疗急性脑梗死的临床疗效及治疗前后血液流变学指标的变化。方法:将发病72h内的入选患者随机分为治疗组及对照组,治疗组采用尿激酶每天20万U联合银杏叶提取物20ml(70mg)静脉滴注,连用10日,后改为阿斯匹林100mg/天;对照组采用血塞通400mg静脉滴注同时口服阿斯匹林200mg/天,10天后改为阿斯匹林100mg/天。两组患者均同时应用钾镁液及对症支持治疗。结果:治疗组自治疗后7天起其神经功能缺损程度评分即显著低于对照组(P<0.05);临床总有效率91.7%,与对照组73.3%相比有显著性差异(P<0.05);治疗后血液流变学各项指标均有所下降,尤以血液粘稠度和纤维蛋白原下降明显,与对照组相比差异显著(均P<0.05)。结论:小剂量尿激酶联合银杏叶提取物静脉滴注治疗发病72h内的急性脑梗死患者简便、安全、有效。
Objective: To investigate the clinical efficacy of low-dose urokinase combined with Ginkgo biloba extract in the treatment of acute cerebral infarction and the changes of hemorrheological indexes before and after treatment. Methods: The patients were randomly divided into treatment group and control group within 72 hours after onset. The treatment group was treated with urokinase 200000 U per day combined with Ginkgo biloba extract 20ml (70mg) for 10 days, then changed to aspirin Lin 100mg / day; control group with Xuesaitong 400mg intravenous infusion of aspirin 200mg / day, 10 days to aspirin 100mg / day. Both groups of patients also applied potassium magnesium solution and symptomatic supportive treatment. Results: The score of neurological impairment in the treatment group was significantly lower than that in the control group (P <0.05) after 7 days of treatment. The total clinical effective rate was 91.7%, which was significantly different from that of the control group (73.3%, P <0.05) ). After treatment, the indexes of hemorheology decreased, especially in blood viscosity and fibrinogen, which were significantly different from those in control group (all P <0.05). Conclusion: Intravenous instillation of low dose urokinase combined with Ginkgo biloba extract in patients with acute cerebral infarction within 72 hours of onset is simple, safe and effective.