| ObjectiveTo investigate the clinical efficacy and safety of urokinase and tirofiban in patients with progressive stroke（SIP）,the clinical control study of urokinase and tirofiban in the treatment of progressive stroke was conducted.MethodsA total of 90 SIP patients who met the inclusion criteria and visited the department of Neurology in Qianfoshan Hospital affiliated to Shandong University from February 1,2018 to April 30,2021 were selected as the research objects.They were divided into group A（urokinase group,30 cases）,group B（tirofiban group,30 cases）and group C（control group,30 cases）.All patients in the three groups were given routine treatment:aspirin enteric-coated tablets 100mg qd and clopidogrel bisulfate tablets 75 mg qd and rosuvastatin calcium tablets 10 mg qd,at the same time,controlling patients’ blood pressure,blood glucose,brain protection,improving collateral circulation and giving symptomatic treatments;Group A:Urokinase was added within 3 hours of symptom progression,and urokinase was given at a rate of 30×104U and pumped intravenously at a rate of 10×104U/h for 3 days.Group B:Tirofiban was added within 3 hours of symptom progression,and was pumped intravenously at a rate of 0.1ug/（kg.min）for 3 days.Group C:Continue with routine treatment.The United States national institutes of health stroke scales were compared before the treatment,3,7 and 14 days after treatment in the three groups during hospitalization;The modified Rankin scale（mRS）scores were observed before treatment and after 90 days of treatment;meanwhile,adverse reactions such as bleeding were observed during the treatment,to compare the clinical efficacy and safety of three treatment methods for progressive stroke.Results1.There were no statistically significant differences in gender,age and other basic data among the three groups（P>0.05）,the three groups were comparable.2.Comparison of treatment effect among the three groups:there was no statistically significant differences in NIHSS scores among the three groups before treatmen,3,7 and 14 days after treatment（P>0.05）.There were no statistical difference in mRS scores among the three groups before treatment（P>0.05）;90 days after treatment,mRS scores of group A and B were compared with group C,respectively,and the differences were statistically significant（P<0.05）;There was no statistical difference between group A and group B（P>0.05）.Comparison of total effective rate among the three groups 14 days after treatment showed that the total effective rate in group A was higher than that in group C,with statistically significant difference(（P<0.05）;Group B was compared with group A and group C,and there was no statistical difference（P>0.05）.3.According to NIHSS score at admission,patients in the three groups were divided into mild（0-6points）,moderate（7-15points）and severe（≥16 points）.According to clinical symptoms,signs and imaging examination,patients in the three groups were divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction,and the two subgroups were compared respectively.The results showed that there was no statistical difference in mRS scores of mild patients before treatment among the three groups（P>0.05）;after 90 days of treatment,mRS scores of of mild patients in group A and group B were significantly different from those in group C（P<0.05）;There was no significant difference between group A and group B（P>0.05）.After 14 days of treatment,the total effective rate of mild patients in group A and group B was higher than that in group C,and the difference was statistically significant（P<0.05）;There was no significant difference between group A and group B（P>0.05）.There was no statistical difference in mRS score of patients with anterior circulation cerebral infarction before treatment among the three groups（P>0.05）;after 90 days of treatment,mRS scores of patients with anterior circulation cerebral infarction in group A were compared with group C,and the difference was statistically significant（P<0.05）.Group B was compared with group A and group C one by one,and there was no statistical difference（P>0.05）.After 14 days of treatment,the total effective rate of patients with anterior circulation cerebral infarction in group A and group B was higher than that in group C,and the difference was statistically significant（P<0.05）;There was no significant difference between group A and group B（P>0.05）.4.Follow-up to 3 months after onset,there was no statistical difference in the incidence of adverse events among the three groups.Conclusions1.Compared with the control group,urokinase can improve the total effective rate after 14 days of treatment for progressive stroke,and both urokinase and tirofiban can improve the total effective rate after 14 days of treatment for patients with mild and anterior circulation progressive stroke.2.Urokinase and tirofiban can improve the prognosis of patients with progressive stroke,and the treatment effect of mild progressive stroke is more significant.In addition,urokinase can improve the prognosis of patients with progressive stroke of anterior circulation.3.Urokinase and tirofiban in the treatment of progressive stroke did not increase bleeding events and other adverse reactions,showing a high safety. |
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