目的 探讨尿激酶联合低分子肝素（LMWH）对脑梗死患者氧化应激相关指标的影响。方法 针对2015年1月—2018年1月在西安市杨凌示范区医院接受治疗的104例脑梗死患者进行回顾性分析，将采用LMWH治疗纳入对照组（n=52），采用尿激酶联合LMWH治疗纳入观察组（n=52），连续治疗7 d。比较两组疗效，氨基末端脑钠肽前体（NTproBNP）、D-二聚体、氧化修饰低密度脂蛋白（Ox-LDL）、谷胱甘肽过氧物酶（GSH-Px）水平等相关因子水平及不良反应情况。结果 观察组总有效率为90.38%，高于对照组的73.08%，差异有统计学意义（P<0.05）。治疗前，两组NT-proBNP、D-二聚体、Ox-LDL、GSH-Px水平均无统计学差异。两组治疗后NT-proBNP、D-二聚体水平均显著下降（P<0.05）；同时观察组治疗后NT-proBNP、D-二聚体水平显著低于对照组（P<0.05）。治疗后两组Ox-LDL水平显著下降（P<0.05）；且观察组显著低于对照组（P<0.05）。治疗后两组GSH-Px水平显著上升（P<0.05），且观察组显著高于对照组（P<0.05）。两组治疗后均出现皮下瘀斑等不良反应，两组差异无统计学意义。结论 尿激酶联合LMWH临床疗效显著，可有效降低NTproBNP、D-二聚体及Ox-LDL水平，提高患者GSH-Px水平。
Objective To investigate the effect of LMWH combined with urokinase on ox-LDL and GSH-Px levels in patients with cerebral infarction.Methods A retrospective analysis of 104 patients with cerebral infarction received treatment in our hospital from January 2015 to January 2018. LMWH was used in the control group, and LMWH combined with urokinase was used in the observation group. The curative effect and the level of related factors were compared between the two groups. Results The total effective rate of the observation group was 90.38% higher than that in the control group (P<0.05). After treatment, the level of NTproBNP, D-dimer in both groups decreased significantly (P<0.05), and that in the observation group was significantly lower than that in the control group (P<0.05). And the level of Ox-LDL in the two groups decreased significantly (P<0.05), and the study group was lower than that in the control group (P<0.05). The level of GSH-Px in the two groups increased significantly after treatment, and the level of GSH-Px in the study group was higher than that in the control group (P<0.05). The adverse reactions such as subcutaneous ecchymosis appeared in both groups after treatment, but there was no significant difference between the two groups (P<0.05). Conclusion LMWH combined with urokinase the he clinical curative effect is remarkable. It can effectively reduce the level of NT-proBNP, D-dimer and ox-ldl, and increasing the level of GSH-Px.