Influencing factors of re-occlusion after intravenous thrombolysis of alteplase in patients with cerebral infarction and therapeutic effect of tirofiban
- VernacularTitle:阿替普酶静脉溶栓治疗脑梗死患者的再闭塞影响因素及替罗非班治疗效果
- Author:
Zhonghai XU
1
;
Yunyi DAI
;
Yu MA
;
Quande DAI
Author Information
- Keywords: cerebral infarction; alteplase; intravenous thrombolysis; re-occlusion; tirofiban; treatment effect
- From: Journal of Clinical Medicine in Practice 2024;28(2):28-31,37
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the influence factors of re-occlusion after intravenous thrombol-ysis of alteplase in patients with cerebral infarction and the therapeutic effect of tirofiban.Methods A total of 100 patients with cerebral infarction were selected as the study objects.The patients were di-vided into occlusion group(n=42)and non-occlusion group(n=58)according to whether re-occlu-sion after intravenous thrombolysis with alteplase.The occlusion group was given tirofiban treatment.General data were compared between two groups.Logistic regression model was used to analyze the in-fluencing factors of re-occlusion after alteplase intravenous thrombolysis in patients with cerebral infarc-tion.The total effective rate,recombinant human tissue plasminogen activator(rPA),plasminogen acti-vator inhibitor-1(PAI-1)levels and the score of National Institutes of Health Stroke Scale(NIHSS)and Simple Mental State Scale(MMSE)in the occlusion group were observed.Results There were statistically significant differences in type 2 diabetes mellitus,blood glucose,systolic blood pressure,NIHSS score and onset-thrombolysis time between the two groups(P＜0.05).Logistic regression a-nalysis showed that type 2 diabetes mellitus,blood glucose,systolic blood pressure,NIHSS score,and onset-thrombolytic time were the influential factors of re-occlusion after intravenous thrombolytic alte-plase in cerebral infarction patients(P＜0.05).The total effective rate was 88.10％(37/42)in 42 pa-tients with re-occlusion after thrombolytic therapy.After 3 and 7 days of treatment,rPA was significantly higher than before treatment,PAI-1 was significantly lower than before treatment(P＜0.05);after 1 week,2 and 4 weeks of treatment,MMSE score was significantly higher than before treatment,NIHSS score was significantly lower than before treatment(P＜0.05).Conclusion Type 2 diabe-tes mellitus,blood glucose,systolic blood pressure,NIHSS score,and time of onset and thrombolyt-ic therapy may affect the re-occlusion of patients with cerebral infarction after alteplase intravenous thrombolytic therapy.The effect of tirofiban after re-occlusion is better,which is beneficial to im-prove the neurological function,rPA and PAI-1 levels of patients.
