| Purpose To detect the effectiveness and safety of the rt PA venous thrombolytic therapy and combination with Urinary kallidinogenase within 24 hours on cerebral ischemic stroke patients.Methods According to the inclusion and exclusion criteria,80 cerebral ischemic stroke patients treated in Zhucheng People 's Hospital from June 2016 to Aug 2017 enrolled in our study,and they were assigned randomly to treatment group and control group,40 patients each group.symptomatic and supportive treatment,enousthrombolytic therapy,neuroprotective therapy,blood activating therapy and complication therapy were given to both treatment group and control group,Urinary kallidinogenase was given only in treatment group within 24 hours.NIHSS scale and MESSS scale were used to investigate the neurologic impairment situation.MMSE scale was used to know the neurobehavioral cognitive status of the patients.The effective rate of therapy was evaluated according to the improvement of neurologic impairment situation and symptoms.The Barthel index was used to evaluate the daily living ability of the patients.SF-36 scale was used to investigate the quality of life after 6 months.SPSS21.0 software was used to data analysis.Results The age,gender,MESSS scores,severity of cerebral infarction,incidence of underlying disease has no statistical difference between treatment group and control group.The NIHSS scores of treatment group at 24 h,3d?7d?14d and 28 d after venous thrombolytic therapy were 9.7 ± 3.8 ? 7.8 ± 2.7 ? 7.4 ± 2.5 ? 5.9 ± 2.3 and 4.6 ±2.5,respectively,the scores at 3d?14d and 28 d were higher than control group(P<0.05).There was no statistical rise on MMSE scores in both treatment group and control group(P>0.05).There were 1 and 6 vascular dementia patients in treatment group and control group,respectively,the incidence of vascular dementia in treatment group and control group were 2.5% and 15.0%,the incidence of vascular dementia of treatment group was lower than control group(c2=3.914,P=0.048).The Barthel scores of treatment at 7d?14d and 28 d after enous thrombolytic therapy were 36.8±14.7?51.0±15.6.2 and 62.8±18.8,respectively,the scores of treatment at 14 d and 28 day were higher than control group(t=2.089,P=0.040;t=2.307,P=0.024).The effective rate of treatment group and control group were 90.0% and 77.5% and there was no statisticaldifference(c2=2.296,P=0.130),however,the proportion of cure and markedly was 77.5%,which is higher than control group(c2=4.528,P=0.033).blood viscosity test shows a downswing in both treatment group and control group,and the high blood viscosity and low blood viscosity of treatment group were better than control group(t=2.326,P=0.023;t=2.499,P=0.015).The test of SF-36 show that the RP,RE,MH,VT and GH of treatment group were better than control group.There no severe adverse events in both treatment group and control group,there is no statistical difference in incidence of adverse events between treatment group and control group.Conclusion(1)Urinary kallidinogenase within 24 h after rt PA venous thrombolytic therapy could improve the neurologic impairment situation of cerebral ischemic stroke patients.(2)Urinary kallidinogenase within 24 h after rt PA venous thrombolytic therapy could improve Activities of Daily Living and motor ability,and lay a better foundation for rehabilitation.(3)Urinary kallidinogenase within 24 h after rt PA venous thrombolytic therapy could improve the ability of learning and memory,and decrease the incidence of vascular dementia.(4)Urinary kallidinogenase within 24 h after rt PA venous thrombolytic therapy could reduce the blood viscosity,the platelet aggregation,and then reduce the possibility of thrombogenesis,decrease the incidence of the second stroke.(5)Urinary kallidinogenase within 24 h after rt PA venous thrombolytic therapy could Improve the quality of life of cerebral ischemic stroke patients. |
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