The Study Of Defibrinolysis,Anticoagulant Therapy And Therapeutic Alliance In Acute Ischemic Stroke

Background and PurposeAlthough intravenous recombinant tissue plasminogen activator (r-tPA) administration is an effective therapy for ischemic stroke when initiated with 3 hours and possibly up to 6 hours after symptom onset, the cost of r-tPA and thrombolysis therapy is expensive for most of Chinese patients . During the past twenty years ,there were a great number of trials in defibrinolysis therapy and in anticoagulant therapy .None of these trials assessed the effects and safety of therapy which combines defibrinolysis with anticoagulant therapy.Hoping to find a substitutive way for acute ischemic stroke ,we compare the efficacy and safety of therapeutic therapy with single defibrinolysis and single anticoagulant therapy. MethodsAccording to the criterias of National Commission of Neurology, 92 patients with a clinical diagnosis of acute stroke within 24 hours of symptom onset were divided into three groups: Group A, defibrinolysis-treated, Batroxobin 10BU, 5BU, 5BU, were administarated at l,3,5days after diagnosis; Group B, anticoagulnt therapy-treated, Low-molecular-weight heparin subcutaneous injection twice a day for consecutive ten days; Group C, alliance-treated, as same as Group A in the first five days and as Group B in the following ten days .All patients were offered Ticlopidine 0.125 qd. The European StrokeScale (ESS) were assessed before, and after therapy on daysThe Study of Delibrinolysis, AnticoagulahtTherapy and Therapeutic Alliance in Acute Ischemic Stroke Abstract1,7,14,30,90 among three groups. Barthel Index at 90 days were also evaluated. At the same time the safety of the therapeutic alliance was observed. ResultsAll the patients in this prospective study with a diagnosis of acute stroke referred to our two department between March 2001 and October 2001,32 patients (34.78%)were included in group A, 28 patients (31.44%)in group B and 32patients(34.78%)in group C. There is no significant difference in ESS and Barthel Index at 90 days between each two groups. Meanwhile, therapeutic alliance did not increase the incidence of symptomatic intracerebral hemorrhage . ConclusionThis prospective study found no significant difference between therapeutic alliance with single defibrinolysis and single antithrombolysis. Further conclusions can be reached only when more patients have been enrolled and more observation time has been taken.