Efficacy And Prognosis Of Treatment With Tirofiban At Different Time After Intravenous Thrombolysis With Alteplase In Patients With Acute Ischemic Stroke

Objectives To analyze the early and long-term efficacy of tirofiban applied at different time within 24 hours of intravenous thrombolytic therapy with alteplase in patients with acute ischemic stroke,and discusses about the influence of different classification of patients with acute ischemic stroke.Methods 340 patients with acute ischemic stroke after intravenous thrombolysis with alteplase were divided into four groups according to the time of applying tirofiban after thrombolysis: 2h group,2~12h group,12~24h group,and control group(without tirofiban).Finally,329 patients with complete required information were included in this statistical analysis.All patients' NIHSS scores before thrombolysis,24 hours after thrombolysis,7days and 14 days after thrombolysis,and mRS scores at 3 months after thrombolysis were recorded.All patients were observed for complications such as hemorrhage,re-occlusion,and disease progression.Evaluate the safety,efficacy,and prognosis at 3 months of tirofiban in patients with acute ischemic stroke.The selected patients were classified into Large-artery atherosclerosis(LAA),Cardioembolism(CE),Small-artery occlusion(SAO),and other or undetermined/Unknown(SOE/SUE)according to TOAST type,and analyze the clinical efficacy and prognosis at 3 months of applying tirofiban after intravenous thrombolysis with alteplase in patients with acute ischemic stroke of different types.Results 1 The comparison result of the effectiveness of 24 hours after thrombolysis in four groups was P<0.05,and the effect of the 2h group and the 2-12 h group was similar and better(pairwise comparison,P<0.00833).For LAA and SAO patients,the comparison result of the effectiveness of 24 hours after thrombolysis in four groups was P<0.05,and the effectiveness of 2h group was better(pairwise comparison,P<0.00833).There was no significant difference between the tirofiban applying group and control group in CE and SOE/SUE patients(P>0.05).2 The comparison result of the effectiveness of 7 days after thrombolysis in four groups was P<0.05,and the effect of the 2h group and the 2-12 h group was similar and better(pairwise comparison,P<0.00833).For LAA and SAO patients,the comparison result of the effectiveness of 7 days after thrombolysis in four groups was P<0.05,and the effectiveness of the 2h group and the 2-12 h group was similar and better(pairwise comparison,P<0.00833).There was no significant difference between the tirofiban applying group and control group in CE and SOE/SUE patients(P>0.05).3The comparison result of the effectiveness of 14 days after thrombolysis in four groups was P<0.05,and the effect of the 2h group and the 2-12 h group was similar and better(pairwise comparison,P<0.00833).For LAA and SAO patients,the comparison result of the effectiveness of 14 days after thrombolysis in four groups was P<0.05,and the effectiveness of the 2h group and the 2-12 h group was similar and better(pairwise comparison,P<0.00833).There was no significant difference between the tirofiban applying group and control group in CE and SOE/SUE patients(P>0.05).4 The comparison result of prognostic function of four groups at three months after thrombolysiswas P<0.05,and the effect of the 2h group and the 2-12 h group was similar and better(pairwise comparison,P<0.00833).For LAA and SAO patients,there was no significant difference between groups with or without tirofiban or those with tirofiban at different times(P>0.05).There was no significant difference in the prognosis at 3 months between the tirofiban group and the control group with CE and SOE/SU patients(P>0.05).5 In terms of reocclusion and stroke progression,tirofiban group was lower than the control group(P<0.05).6 There was no significant difference between the tirofiban group and the control group in terms of non-symptomatic cerebral hemorrhage,bleeding in the skin,gums and other parts(P>0.05),and no symptomatic cerebral hemorrhage or death occurred in each group.Conclusions 1 Alteplase combined with tirofiban is safe and effective in the treatment of acute ischemic stroke.2 Tirofiban within 12 h after intravenous thrombolytic therapy with alteplase can better improve the clinical symptoms and prognosis at 3 months of acute ischemic stroke patients.3 The clinical symptoms of LAA and SAO patients could be better improved by using tirofiban within 12 h after intravenous thrombolysis therapy with ateptase Table 15;Reference 121...