Efficacy And Safety Analysis Of Tirofiban In The Treatment Of Acute Ischemic Stroke Out Of Time Window

ObjectiveTo investigate the efficacy and safety of intravenous pumping of tirofiban hydrochloride in the treatment of acute ischemic stroke patients with non-cardiogenic and non-severe intracranial and extracranial vascular stenosis with onset time of 6h-24 h and 4 ≤NIHSS < 25 points,and to compare the efficacy of tirofiban hydrochloride in the treatment of anterior and posterior circulation infarction.MethodsA total of 123 cases of acute ischemic stroke patients with non-cardiogenesis and non-severe intracranial and extracranial vascular stenosis who were admitted to the Department of Neurology of The Affiliated Central Hospital of Shenyang Medical College with onset time of 6h-24 h and 4 points ≤NIHSS < 25 points were selected as the study subjects.According to the principle of voluntary choice,patients were divided into experimental group 63 cases,control group 60 cases.Before treatment,all the enrolled patients underwent head magnetic resonance diffusion weighted imaging and magnetic resonance arteriography（DWI+MRA）to determine the infarction site and were grouped again.There were 68 cases of anterior circulation infarction,including 36 cases in the experimental group and 32 cases in the control group.There were 55 cases of posterior circulation infarction,including 27 cases in experimental group and 28 cases in control group.NIHSS and m RS scores were evaluated for all enrolled patients.In the experimental group,routine venous blood collection,blood routine and coagulation items were taken,and platelet count,hemoglobin,hematocrit and activated partial thrombin time were recorded.The experimental group was given intravenous infusion of Tirofiban hydrochloride injection（0.4ug/min·Kg continuous intravenous infusion for 30 min and 0.1ug/min·Kg continuous intravenous infusion）and oral aspirin enteric-coated tablet 100mg/d 48 hours later（aspirin and tirofiban hydrochloride injection overlap for 4 hours）.Blood routine and coagulation items were checked 6hours after tirofiban hydrochloride injection was pumped intravenously.Platelet count,hemoglobin,hematocrit and activated partial thrombin time were recorded again.The control group was given oral aspirin enteric-coated tablet 300mg/d and 100mg/d after24 h.Other medications were the same between the two groups.NIHSS score,m RS score,incidence of bleeding,recurrence,death and other adverse events were compared between the experimental group and the control group after treatment for 30 days.The NIHSS score and m RS score were compared between the experimental group and the control group before and 48 h after treatment.Platelet count,hemoglobin,hematocrit and activated partial thrombin time were compared before and after treatment.The total effective rate,anterior circulation infarction and posterior circulation infarction were compared between the experimental group and the control group.Results1.NIHSS score and m RS score in the experimental group were lower than those in the control group at 48 h,7,14 and 30 days of treatment,with statistical significance（P< 0.05）.2.NIHSS score and m RS score of the experimental group after 48 h of treatment were lower than those before treatment,and the differences were statistically significant（p < 0.05）.3.There were no significant differences in platelet count,hemoglobin,hematocrit and activated partial thrombin time before and 6h after treatment in the experimental group（P > 0.05）.4.The total effective rate and the total effective rate of anterior circulation infarction were different between the experimental group and the control group,and the neurological function improvement of anterior circulation infarction after treatment was significantly improved in the experimental group more than the control group（P <0.05）.There was no significant difference in the total effective rate of posterior circulation infarction（P > 0.05）.5.There was no significant difference in the incidence of bleeding,recurrence,death and other adverse events between the experimental group and the control group（P > 0.05）.ConclusionsTo come on time at 6 h and 24 h,and 4 points ≤ NIHSS < 25 points of time window,the cardiac outside,the severe intracranial vascular stenosis in acute ischemic stroke,vein pump into hydrochloric acid for class had injection can improve its short-term neural functional recovery and healing,and circulate in the former infarction can significantly promote the recovery of neural function,control the progress of stroke,effective and safe.