Effect of high dose urokinase on intraventricular hemorrhage and its influence on inflammatory cytokines in patients / 中国基层医药

ABSTRACT

Objective To observe the effect of high dose urokinase on hemostasis ,tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in patients with intraventricular hemorrhage .Methods 96 patients with intraventricular hemorrhage were selected.They were randomly divided into study group and control group according to the digital table,32 cases in each group.The two groups were treated by bilateral minimally invasive puncture and drainage,the control group was injected with urokinase 20000U/d through the drainage tube,and the study group were injected with urokinase 50000U/d through the drainage tube.The daily hematoma output volume ,the time of ventricular hematoma disappearance ,the duration of cerebrospinal fluid drainage ,the postoperative complications and the levels of TNF-αand IL-6 in different periods were observed and compared between the two groups .Results The time of ventricular hematoma disappearance and the duration of cerebrospinal fluid drainage in the study group were (5.03 ±1.52)d and (3.58 ±1.32)d,respectively,which were shorter than those in the control group [(10.65 ± 3.62)d,(4.82 ±1.40)d].The daily hematoma output volume in the study group was (8.13 ±0.84)mL,which was significantly higher than that of the control group [(5.32 ±0.65)mL],the differences between the two groups were statistically significant(,t =3.462,2.793,3.083,all P <0.05).The incidence rate of postoperative complications in the study group was 2.08%,which was lower than that of the control group (16.67%,χ2 =6.008,P <0.05).The levels of TNF-αand IL-624h after treatment in the study group were (68.26 ±14.20)μg/L,(68.52 ±10.20)μg/L, respectively,which of the control group were (68.25 ±12.65)μg/L,(68.50 ±8.65)μg/L,respectively,and there were no statistically significant differences between the two groups(t =0.382,0.306,all P >0.05).The levels of TNF-αand IL-63d and 7d after treatment in the study group were (88.52 ±18.62) μg/L,(135.60 ±24.52) μg/L, (81.33 ±22.52) μg/L,(97.52 ±16.63) μg/L,respectively,which were lower than those in the control group [(185.65 ±27.41)μg/L,(256.65 ±28.65)μg/L,(90.20 ±18.50)μg/L,(134.52 ±27.65)μg/L,t =12.038, 15.023,7.028,10.048,all P <0.05].Conclusion High dose urokinase is effective in the treatment of intraventric-ular hemorrhage,it can rapidly dissolve hematoma,inhibit TNF-αand IL-6 levels,protect the brain tissue,and the incidence rate of complication is not increased ,which is suitable for clinical promotion .