Clinical Study On The Efficacy And Safety Of Eptifibatide In The Treatment Of Acute Ischemic Stroke

Objective:To investigate the clinical efficacy and safety of eptifibatide in the treatment of acute ischemic stroke（6-48 hours）.Methods:A total of 241 AIS patients who met the criteria and were treated in the Department of Neurology,China-Japan Union Hospital,Jilin University from January2020 to June 2021 were selected as the research objects.They were divided into two groups: the study group（n=115）was treated with eptifibatide,and the control group（n=126）was treated with argatroban.Both groups were treated with conventional drugs.The baseline data of the two groups were collected,including age,sex,history,history of drinking and smoking,PLT,ALT,CREA,TG,CHOL,LDL-C,PT and Hcy.After the treatment,the stroke scale（NHISS score）,Barthel index score,m RS index score,the total effective rate of clinical treatment and the incidence of adverse events were observed and compared between the two groups at 7 days,3 months and 6months.Sub-group analysis was conducted according to TOAST classification,before and after circulation grouping and onset time.SPSS24.0 software was used for statistical analysis.Results:1.At admission,there was no significant difference in baseline data,NHISS score and Barthel index score between the two groups.The total clinical effective rate of patients in the study group and the control group was 96.6% vs92.9%（P > 0.05）7days after treatment.On the 7th day after treatment,the NHISS score（2.59±2.08 vs3.26±2.64,P=0.033）and Barthel index（82.14±15.61 vs 77.78±17.73,P=0.047）in the eptifibatide group were significantly improved compared with those in the argatroban group.After 3 months’ follow-up,it was found that there was no significant difference between the study group and the control group in NHISS score（1.75±1.77 vs2.22±2.23,P=0.079）and the proportion of m RS ≤2 score（82.9% vs 76.5%,P=0.228）.After 6 months’ follow-up,the NHISS score of two groups（1.07±1.61vs1.66±2.41,P=0.030）and the proportion of m R ≤2 score（89.1% vs 87.3%,P=0.674）were counted again.The recurrence rate of cerebral infarction in eptifibatide group was lower than that in argatroban group within 6 months（1.8% vs 7.6%,P=0.041）.2.After TOAST classification,the results showed that there was a statistically significant difference between eptifibatide group and argatroban in the NHISS score of patients with arteriolar occlusion（1.84±1.51 vs 2.56±1.83,P=0.015）.However,there was no significant difference in NHISS score（3.53±2.35 vs 4.57±3.28,P=0.085）between the two groups of patients with atherosclerosis 7 days later.3.The two groups of patients were divided into < 24 h and 24-48 h according to the onset time.The results showed that the NHISS scores of AIS patients with onset time < 24h（2.34±2.17 vs 3.42±2.6,P=0.006）were significantly lower in the eptifibatide group 7 days after treatment than those with argatroban.At the onset time of 24-48 h,there was no significant difference in NHISS scores between the two groups at 7 days after treatment（3.27±1.66 vs 3.06±2.7,P=0.702）.4.The efficacy of eptifibatide in the treatment of AIS patients was simply observed,which was divided into two groups according to the time of onset: <24hours and 24-48 hours.The results showed that the clinical effect of eptifibatide treatment with the time of onset less than 24 hours was better than that of patients admitted to hospital 24-48 hours later（NHISS score: 2.34 ± 2.17 vs 3.27±1.67,P=0.036）,and the eptifibatide group was divided into two groups according to location of infarction.The results showed that there was no significant difference between the two groups in NHISS score（2.73±2.22 vs 2.40 ±1.88,P=0.396）at 7 days after treatment.5.In this study,there were 1 headache,2 cases of stomach discomfort,2 cases of nausea and vomiting,1 case of gastrointestinal bleeding,2 cases of gingival bleeding and 3 cases of death in the eptifibatide group（study group）,and 3 cases of headache,1 case of stomach discomfort,1 case of gingival bleeding and 2 cases of death in the argatroban group（control group）.The total incidence rate of total adverse reactions between the two groups（9.6% vs 5.6%,P=0.237）was not statistically significant.The half-year mortality rate of patients in the study group was 0.87%,while that of patients in the control group was 1.59%.The difference between them was not statistically significant（P>0.05）.Conclusion:1.Both eptifibatide and argatroban can significantly improve the clinical prognosis of patients with AIS（6-48h）,and they are safe and stable during the medication period.2.Compared with argatroban,eptifibatide can significantly improve the clinical efficacy of acute cerebral infarction with onset time less than <24h and arteriolar occlusion.It can reduce the recurrence rate of cerebral infarction in AIS patients within half a year.3.The clinical effect of eptifibatide on AIS patients whose onset time is less than < 24 h is better than that of AIS patients admitted to hospital within24-48 h.Eptifibatide is recommended for AIS patients whose onset time exceeds the thrombolytic time window and within 48 h.