The Clinical Treatment Of The Elderly Patients With Transient Ischemic Attack Using Small Dose Of Urokinase Therapy

PurposeThe research aims to investigate the clinical impacts and analyze the mechanismof the therapy combined with small dose of urokinase and conventional therapies onreoccurrence, coagulation and carotid atherosclerosis plaques of transient ischemicattack (TIA) in old patients.MethodThe fifty-three elderly patients with TIA who received the treatment fromAugust2012to October2013(10months) in our hospital were randomly divided intogroup A (Urokinase therapy) and Group B (Conventional therapies). Among which,there are27patients (17males and10females with the age range of80.11±3.17yearsold) in group A. They were treated with the therapy combined with100,000Uurokinase and conventional therapies for the controlling risk factors (usingantihypertensive, hypoglycemic and lipid-lowering therapies to stabilize plaque,anti-platelet aggregation and improving cerebral circulation) for two weeks; while ingroup B,26patients (15males and11females at the79.96±4.31years old) were received treatment using conventional therapies for2weeks. To evaluate the clinicaleffect and reliability of the therapy proposed, the authors made comparisons on thetwo groups and the comparisons within each group in terms of the occurrences,coagulations and average areas of the carotid atherosclerosis plaques before and aftertreatment.ResultsTotal effective rates were presented as follows: in group A, there were13patients with significant effects,8patients with good effects, and6patients with littleeffects. Meanwhile, no worsening cases were observed in this group, the totaleffective rate was77.8%; while in Group B, There were7patients with significanteffects,5patients with good effects,12patients with little effects and2worseningpatients; the total effective rate was46.2%. The differences of the total effective ratesbetween two groups were remarkable and of statistical significance.The coagulation variations were demonstrated as following: by comparing thedata of APTT, PT and INR before and after treatments, both group A and group Bpresented no apparent differences, showing no statistical significance (P>0.05); Thecomparisons of APTT, PT and INR after treatment in both group A and B showedlittle variation which indicated no statistical significance (P>0.05); The Fbg. and DDdecreased apparently in group A after treatment and presented statistical significance(P<0.05); in group B, they showed little difference with no statistical difference(P>0.05). In comparison the Group A and B after treatment, Fbg. and DD in group Awere obviously smaller than that of group B, presenting statistical significance(P<0.05).Regarding the variations of average area of carotid atherosclerosis plaque, theaverage area of the plaque in group A after treatment decreased with statisticalsignificance (P<0.05); In group B, there was no apparent variation being found in theaverage area of the plaque after treatment, with no statistical significance (P>0.05);The comparisons of two groups after treatment showed that the average area in groupA decreased more obviously than that of group B with statistical significance(P<0.05).For Reliability, no bleedings were observed in central nervous system and other parts.ConclusionsThe clinical effect of the therapy combined with urokinase and conventionaltherapies in the treatment of elderly patients with TIA is proved to be superior toconventional therapies. Besides, there are no bleeding risks in the treatment andpresented high reliability for elderly patients.