Abstract
To evaluate the clinical effects of thrombolytic therapy with Urokinase and heparin for acute stroke, functional outcome at the end of 3 month has been studied on 87 cases with clinically diagnosed lacunar infarct in a prospective controlled trial.
Eighty-seven patients less than 72 hours duration with first lacunar infarction were divided in a randomized trial into two groups; UK group (n=43) consist of 18 cases (High-dose UK-H group) with high-does UK (Total 3, 040, 000 I.U./two weeks) and heparin (5, 000-2, 500 I.U./day) administration, and 26 cases (Low-dose UK-H group) with low-dose UK (Total 840, 000 I.U./two weeks) and heparin (2, 500 I.U./day) administration; control group (N=44) without UK nor heparin. Each group had little differences with age, risk factors (Hypertension, Diabetes Mellitus, Atrial fibrillation), distribution of the gradings of weakness at lower limb, and timing on rehabilitation. And all the patients were examined by cerebral angiography and CT scan.
In the patients with severe weakness at lower limb (0/5-2/5 in DeJong's gradings), the outcome in UK-H subgroup (n=12) was better than that in control subgroup (n=14) (p<0.05). And the improvement of the paresis within two weeks after stroke was observed in ten cases of UK subgroup (N=12) consist of the patients with severe weakness, but in 7 cases in control subgroup (n=14). In the patients with moderate or slight weakness (more than 3/5 in DeJong' gradings), there were no differences in functinal outcome at 3 months between UK-H subgroup and control subgroup. And there were no differences in functional outcome between High-dose UK-H group and Low-dose UK-H group.
