Effectiveness and safety of low molecular weight heparin combined with urokinase thrombolytic therapy in treating elderly patients with acute ischemic stroke
10.3969/j.issn.1009-0126.2025.11.003
- VernacularTitle:低分子肝素联合尿激酶溶栓治疗老年急性缺血性脑卒中患者的有效性及安全性
- Author:
Jie LIU
1
;
Zehao CAI
;
Chun SUN
;
Aihua GAO
;
Hui LIU
Author Information
1. 武汉市第一医院神经内科,武汉 430030
- Publication Type:Journal Article
- Keywords:
heparin,low-molecular-weight;
urokinase-type plasminogen activator;
stroke;
coagulation status;
neurological function
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(11):1454-1457
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effectiveness and safety of low molecular weight heparin(LMWH)combined with urokinase thrombolysis in the treatment of elderly patients with acute ischemic stroke(AIS).Methods A total of 132 elderly AIS patients admitted in Department of Neurology of Wuhan No.1 Hospital from January 2023 to September 2024 were recruited,and randomized into control group,group A,group B and group C,with 33 cases in each group.Besides urokinase thrombolysis as basic treatment,the patients in groups A,B and C were given LMWH within 24,24-47 and 48-72 h after thrombolysis,respectively.After 1 week of treatment,the incidence rate of cerebrovascular re-occlusion was compared among the four groups.Plasma prothrombin time(PT),platelet count(PLT),fibrinogen(Fib),nerve growth factor(NGF),neuron-specific enolase(NSE),neurotrophic factor(NTF)and National Institutes of Health Stroke Scale(NIHSS)score were compared before and after treatment and among the four groups.The incidences of adverse reactions were also compared among them during treatment.Results Compared with the levels before treatment,the levels of NGF and NTF were significantly increased,while the PT,PLT,Fib and NSE levels and NIHSS score were obviously decreased in the four groups after 1 week of treatment(P＜0.05).At 1 week of treatment,group A obtained notably higher NGF and NTF levels,and remarkably lower PT,PLT,Fib and NSE levels and NIHSS score than the other three groups(P＜0.05).So were group B when compared with group C and control groups(P＜0.05),and group C when compared with control group(P＜0.05).There was no statistical significance in the comparison of total incidence rate of adverse reactions during treatment among the four groups(P＞0.05).Conclusion LMWH combined with urokinase thrombolytic therapy can effectively improve the coagulation status and neurological function for elderly AIS patients,and the earlier it is applied,the better the efficacy will be.
