目的 探討尤瑞克林對不同結構性影像類型進展性腦梗死的CT與臨床效果。 方法 2007年3月－2011年6月按入院時不同結構性影像類型將進展性腦梗死分為大灶梗死、中灶梗死、小灶梗死及腔隙梗死4型，共235例，采用分層隨機分組的方法將患者分為尤瑞克林組（治療組）119例，對照組116例。兩組基礎用藥均為疏血通6 mL+生理鹽水250 mL靜脈滴注，胞磷膽堿0.5 g+生理鹽水250 mL靜脈滴注，阿司匹林0.1 g口服，以上用藥均為1次/d，連用4周。治療組同時給予生理鹽水100 mL+尤瑞克林0.15 PNAu靜脈滴注，對照組同時給予生理鹽水100 mL靜脈滴注，1次/d，連用7～14 d，兩組治療前后均測量梗死的最大層面最大梗死灶的長度與寬度，計算并記錄梗死面積；統計分析各型的臨床療效。 結果 ① 梗死面積改變：治療前各亞型治療組與對照組梗死面積差異均無統計學意義（P＞0.05）；治療后，大灶梗死組、中灶梗死組、小灶梗死組中的治療組梗死面積均比治療前顯著縮小（P＜0.01），而對照組的梗死面積較治療前差異無統計學意義（P＞0.05）；腔隙梗死組中，治療組及對照組治療后梗死面積均無明顯改變（P＞0.05）。② 臨床療效：各亞型進展性腦梗死，治療組均取得優于對照組的效果；大灶梗死及中灶梗死的顯著進步率分別為47.6%和66.7%，而對照組的顯著進步率分別為0.0%和33.3%。 結論 大灶梗死組、中灶梗死組、小灶梗死組進展性腦梗死使用尤瑞克林治療后梗死面積均比治療前明顯縮小；各亞型進展性腦梗死使用尤瑞克林后臨床療效均優于對照組，尤其是大灶梗死及中灶梗死的臨床效果更加顯著。
Objective To assess the efficacy and safety of human urinary kallidinogenase injection (HUK) in treating patients with acute ischemic stroke. Methods Through adopting Cochrane systematic review methods, the relevant materials were retrieved by electronically and manually searching databases and claimed from pharmaceutical factories, so as to collect the randomized controlled trials (RCTs) about HUK for the patients with acute ischemic stroke, which were searched by the end of October 2010. The quality of each trial was assessed by two reviewers independently, and meta-analysis was conducted by using RevMan 5.0.2 software. Results Twenty-four trials involving 2 433 patients were included, of which 2 were multi-center placebo controlled trials, and the other 22 were all non-placebo trials. Only 2 trials (459 cases) reported the death or dependence at the end of 3-month follow-up. In those trials, HUK reduced death or dependency comparing to the control group (RR=0.69, 95%CI 0.55 to 0.86). Twenty trials (2 117 patients) reported the proportion of patients with marked neurological improvement after finishing the 7 to 21 days treatment. Meta-analysis showed the HUK group had more neurological improvement than the control group, with significant differences (RR=1.56, 95%CI 1.44 to 1.70). Fifteen trials reported adverse events, of which the transient hypotension was commonly seen (1.5%-5.1%). Non-fatal intracerebral hemorrhage was detected in 7 patients in 3 trials, but the difference between the HUK group (6 patients, 1.2%) and the control group (1 patient, 0.4%) was not significant (RR=1.82, 95%CI 0.34 to 9.61). Deaths occurred in both HUK group (2 patients, 0.4%) and the control group (1 patient, 1.1%) in 2 trials, without significant differences (RR=0.6, 95%CI 0.09 to 3.92). No trial assessed quality of life. Conclusion Available evidence suggests that HUK injection reduces neurological impairment after acute ischemic stroke and improves long-term outcomes, though a few patients suffer from transient hypotension. Further high-quality, large-scale RCTs are needed to confirm these results.