老年短暂性脑缺血发作经小剂量尿激酶治疗临床分析
发布时间：2018-10-30 06:26
【摘要】：目的 对小剂量尿激酶联合常规治疗老年短暂性脑缺血发作（TIA）的症状再发、凝血功能以及颈动脉粥样硬化斑块的临床影响进行对比分析并探讨其作用机制。 方法 把2012年8月~2013年10月期间在我院治疗的满足入组条件的53例老年短暂性脑缺血发作患者随机分为A、B两组，A组为尿激酶治疗组，B组为常规治疗组。A组27例（男性17例，女性10例，年龄80.11y±3.17y），应用10万U尿激酶联合常规治疗（即控制血压、控制血糖、降脂稳定斑块、抗血小板聚集、改善脑循环等控制危险因素治疗）2周；B组26例（男性15例，女性11例，年龄79.96y±4.31y），应用常规治疗2周。对两组治疗前后的症状再发、凝血功能以及颈动脉粥样硬化斑块平均面积进行组间及组内的对比分析，从而评估该治疗方案的临床疗效及安全性。 结果 1、总有效率：A组显效13例，有效8例，无效6例，恶化0例，总有效率77.8%；B组显效7例，，有效5例，无效12例，恶化2例，总有效率46.2%，两组总有效率对比有明显差异，具统计学意义（P＜0.05）。 2、凝血功能变化：A组治疗前后APTT、PT、INR数据对比，其变化无明显差异，不具统计学意义（P＞0.05），B组治疗前后APTT、PT、INR数据对比，其变化无明显差异，不具统计学意义（P＞0.05）；A、B两组治疗后APTT、PT、INR数据对比，其变化无明显差异，不具统计学意义（P＞0.05）；A组治疗后其Fbg.、DD明显下降，具统计学差异（P＜0.05），B组Fbg.、DD治疗前后数据对比，变化无明显差异，不具统计学意义（P＞0.05）；A、B两组治疗后对比，A组Fbg.、DD较B组有明显下降，具统计学差异（P＜0.05）。 3、颈动脉粥样粥样硬化斑块平均面积变化：A组治疗后颈动脉粥样硬化斑块平均面积缩小有统计学意义（P＜0.05），B组治疗前后颈动脉粥样硬化斑块平均面积变化无明显差异，不具统计学意义（P＞0.05）。A、B两组治疗后对比，A组颈动脉粥样硬化斑块平均面积较B组缩小，具统计学差异（P＜0.05）。 4、安全性：两组均无中枢神经系统或其他部位出血情况发生。 结论 小剂量尿激酶联合常规治疗老年短暂性脑缺血发作临床疗效优于常规治疗；且该治疗方案未见增加老年患者的出血风险，对于老年患者安全性高。
[Abstract]:Objective to compare and analyze the clinical effects of low-dose urokinase combined with routine therapy on the recurrence of symptoms, coagulation function and carotid atherosclerotic plaque in elderly patients with transient ischemic attack (TIA). Methods from August 2012 to October 2013, 53 elderly patients with transient ischemic attack were randomly divided into two groups: group A: urokinase group. Group A (M 17, F 10; age 80.11y 卤3.17y) was treated with 100000 U urokinase combined with routine therapy (control of blood pressure, control of blood glucose, stable plaque, anti-platelet aggregation). Improvement of cerebral circulation and other risk factors were treated for 2 weeks. Group B (M 15, F 11; age 79.96 y 卤4.31 y) was treated with routine therapy for 2 weeks. The symptom recurrence, coagulation function and average area of carotid atherosclerotic plaque before and after treatment were compared and analyzed between the two groups, so as to evaluate the clinical efficacy and safety of the treatment regimen. Results 1. The total effective rate was 13 cases in group A, 8 cases in effective group, 6 cases in ineffectiveness, 0 cases in aggravation, and 77.8% in total effective rate; In group B, there were 7 cases of remarkable effect, 5 cases of effective, 12 cases of failure and 2 cases of deterioration. The total effective rate was 46.2%. There was significant difference in total effective rate between the two groups (P < 0.05). 2the change of coagulation function: APTT,PT,INR data of group A had no significant difference before and after treatment, but there was no significant difference in APTT,PT,INR data before and after treatment in group A (P > 0. 05), but there was no significant difference in APTT,PT,INR data before and after treatment (P > 0. 05). There was no statistical significance (P > 0.05). There was no significant difference in APTT,PT,INR data between the two groups after treatment (P > 0. 05). The Fbg.,DD of group A was significantly decreased after treatment (P < 0. 05). There was no significant difference in Fbg.,DD data before and after treatment in group A (P > 0. 05). After treatment, Fbg.,DD in group A was significantly lower than that in group B (P < 0. 05). 3The mean area of carotid atherosclerotic plaque decreased significantly in group A after treatment (P < 0.05). There was no significant difference in the mean area of carotid atherosclerotic plaques before and after treatment in group B. there was no significant difference between the two groups (P > 0.05). After treatment, the mean area of carotid atherosclerotic plaques in group A was smaller than that in group B (P > 0.05). There was statistical difference (P < 0.05). 4, safety: no central nervous system or other bleeding occurred in both groups. Conclusion low dose urokinase combined with routine therapy is superior to conventional therapy in the treatment of transient cerebral ischemic attack in elderly patients, and it is safe for elderly patients because it does not increase the risk of hemorrhage in elderly patients.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3
[Abstract]:Objective to compare and analyze the clinical effects of low-dose urokinase combined with routine therapy on the recurrence of symptoms, coagulation function and carotid atherosclerotic plaque in elderly patients with transient ischemic attack (TIA). Methods from August 2012 to October 2013, 53 elderly patients with transient ischemic attack were randomly divided into two groups: group A: urokinase group. Group A (M 17, F 10; age 80.11y 卤3.17y) was treated with 100000 U urokinase combined with routine therapy (control of blood pressure, control of blood glucose, stable plaque, anti-platelet aggregation). Improvement of cerebral circulation and other risk factors were treated for 2 weeks. Group B (M 15, F 11; age 79.96 y 卤4.31 y) was treated with routine therapy for 2 weeks. The symptom recurrence, coagulation function and average area of carotid atherosclerotic plaque before and after treatment were compared and analyzed between the two groups, so as to evaluate the clinical efficacy and safety of the treatment regimen. Results 1. The total effective rate was 13 cases in group A, 8 cases in effective group, 6 cases in ineffectiveness, 0 cases in aggravation, and 77.8% in total effective rate; In group B, there were 7 cases of remarkable effect, 5 cases of effective, 12 cases of failure and 2 cases of deterioration. The total effective rate was 46.2%. There was significant difference in total effective rate between the two groups (P < 0.05). 2the change of coagulation function: APTT,PT,INR data of group A had no significant difference before and after treatment, but there was no significant difference in APTT,PT,INR data before and after treatment in group A (P > 0. 05), but there was no significant difference in APTT,PT,INR data before and after treatment (P > 0. 05). There was no statistical significance (P > 0.05). There was no significant difference in APTT,PT,INR data between the two groups after treatment (P > 0. 05). The Fbg.,DD of group A was significantly decreased after treatment (P < 0. 05). There was no significant difference in Fbg.,DD data before and after treatment in group A (P > 0. 05). After treatment, Fbg.,DD in group A was significantly lower than that in group B (P < 0. 05). 3The mean area of carotid atherosclerotic plaque decreased significantly in group A after treatment (P < 0.05). There was no significant difference in the mean area of carotid atherosclerotic plaques before and after treatment in group B. there was no significant difference between the two groups (P > 0.05). After treatment, the mean area of carotid atherosclerotic plaques in group A was smaller than that in group B (P > 0.05). There was statistical difference (P < 0.05). 4, safety: no central nervous system or other bleeding occurred in both groups. Conclusion low dose urokinase combined with routine therapy is superior to conventional therapy in the treatment of transient cerebral ischemic attack in elderly patients, and it is safe for elderly patients because it does not increase the risk of hemorrhage in elderly patients.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3
【参考文献】
相关期刊论文 前7条
1 李晓晔,吴红,姜茹,柳巍,许兵;糖尿病和贫血患者血浆中乳酸质量浓度的测定[J];第四军医大学学报;2000年04期
2 李继锋,王舟,李宪章,徐存理,孔庆霞;短暂性脑缺血发作概念的再探讨(附526例临床分析)[J];山东医药;2000年01期
3 周承;罗勇;;缺血性脑血管疾病中联合应用神经保护剂研究现状[J];医学综述;2012年06期
4 杨美菊;朱红军;陆士奇;;短暂性脑缺血发作的研究进展[J];中国急救医学;2006年04期
5 孔凡兰;;小剂量尿激酶治疗短暂性脑缺血发作60例疗效分析[J];中国医学创新;2011年20期
6 郭炜;蔡款;钱东翔;王智坚;李s
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