| Objectives The study compared the 7-day short-term outcomes and 3-month long-term outcomes of patients treated with continuous low-dose urokinase therapy for Progressive stroke(PIS)with those who did not receive low-dose urokinase therapy.To evaluate the clinical efficacy and safety of continuous pumping of low-dose urokinase in the treatment of PIS,and to provide a better clinical efficacy and safer regimen for the treatment of PIS patients.Methods The clinical data of 141 patients with PIS admitted to the Department of Neurology of Tangshan Workers’ Hospital from January 2018 to December 2021 were retrospectively analyzed.All of these patients met the criteria of large atherosclerosis(LAA)with TOAST classification within 72 hours from onset to progression.These patients were divided into observation group and control group according to whether they had received low-dose urokinase pumping therapy.Fifty-one patients in the observation group received low-dose urokinase pumping after disease progression,and 90 patients in the control group received other treatments.National Health Score Scale(NIHSS)scores for both groups were collected at admission,after progression,and after medication to assess neurological deficits.Moreover,the NIHSS score of the two groups was compared after treatment and the changes were compared,and the clinical effect of low-dose urokinase in the treatment of PIS was proved by comparison.The probability of adverse events during treatment may further reflect the safety of low-dose urokinase therapy for PIS.Long-term outcomes were assessed by modified Rankin scale score(m RS score)at 3-month follow-up,and all patients with LAA PIS were classified according to the Oxfordshire Community Stroke Programme classification(OCSP classification)to compare the clinical effect of low-dose urokinase on anterior and posterior circulation infarction.Results 1 after 7 days of treatment,NIHSS scores in both the observation group and the control group decreased compared with before treatment,and the difference was statistically significant(P<0.05).2 The NHISS score of the observation group was lower than that of the control group after 7 days of treatment,and the difference was statistically significant(P=0.002).3 After 7 days of treatment,NIHSS improvement rate ≥2 points between the two groups was 65% in the observation group and 31% in the control group.The NIHSS improvement rate ≥2 in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.01).4 after 3 months of treatment,the good prognosis rate of the observation group was significantly higher than that of the control group,and there was statistical difference between the two groups(P=0.026).5 The NIHSS improvement rate of ≥2 in the observation group was 69.0% at 7days after treatment of anterior circulation infarction.The control group was 34%,the observation group was higher than the control group,and the results of statistical analysis were statistically significant(P=0.005).NIHSS improvement ≥2 in the observation group was 60% after 7 days of treatment for posterior circulation infarction.The control group was 27%,the observation group was significantly higher than the control group,and the results were statistically different(P=0.007).After 7 days of treatment,the NIHSS improvement rate of ≥2 score in the observation group was 69% in the anterior circulation,higher than 60% in the posterior circulation of the same group,but the difference was not statistically significant(P=0.490).6 The incidence of adverse events was 2.0% in the observation group and 3.0% in the control group during treatment,and there was no significant difference in the incidence of adverse events between the two groups(P=0.637).Conclusions 1 according to individual situation,continuous pumping of low-dose urokinase(≤500IU/kg/h)for 48-72 hours can significantly improve the degree of neurological impairment in patients with PIS.2 Compared with other treatment regimens,continuous pumping of low-dose urokinase(≤500IU/kg/h)for 48-72 hours in the treatment of progressive stroke did not increase the incidence of bleeding and other adverse events,and had a certain safety.3 there was no significant difference in the effect of low-dose urokinase pumping in PIS patients before and after treatment.Figure 0;Table 8;Reference 114... |
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