The Effectiveness And Safety Of Defibrinogenating Agent Combined With Antiplatelet Therapy In Treatment Of Acute Minor Stroke

Background and purposeThe CHANCE study has shown that early usage of dual antiplatelet therapy in the treatment of acute minor stroke results in a better outcome and do not increased risk.In addition,current guidelines recommended selectively choose thrombolytic therapy for patients with acute minor stroke who may have sequela of functional disability.However,in clinical practice,most patients have exceeded the time window when they were admitted to hospital,and not all patients were eligible for antiplatelet drugs.The purpose of this study was to investigate whether usage of batroxobin could improve the clinical efficacy and prognosis of patients with minor stroke in addition to antiplatelet drug therapy within 24 hours of onset.MethodsWe retrospectively analyzed the clinical data of patients with acute minor stroke from September 2020 to July 2021,hospitalized in the Department of Neurology,The First Affiliated Hospital of Harbin Medical University,and they were treated with antiplatelet drugs and batroxobin both within 24 hours.According to inclusion and exclusion criteria,a total of 318 subjects were included in this experiment.According to whether batroxobin was used or not,it was divided into control group(antiplatelet drug therapy)and combined group(plus batroxobin on the basis of antiplatelet drug therapy).Collecting data included basement data and experimental data:age,sex,smoking,alcohol consumption,weight,hypertension,glycosylated hemoglobin,blood coagulation function index on admission,fasting glucose,the NIHSS score of admission and discharge,diabetes,FIB values of combined group after treatment,blood homocysteine,blood lipid level,history of ischemic stroke,history of atrial fibrillation,infarction area,m RS score was followed up by telephone three months after discharge.SPSS24.0 software was used for statistical analysis.Results1.The NIHSS score of control group and combined group were both significantly lower than before after treatment.In the combined group,136 cases were effective,22 cases were ineffective or deteriorated,and the effective rate was 86.08%.In the control group,124 cases were effective,36 cases were ineffective or deteriorated,and the effective rate was 77.50%.There was statistically significant difference in efficacy between the two groups(χ~2=3.921,P<0.05).2.There was no statistically significant difference in efficacy between three groups:within 6 hours of onset,6 hours to 12 hours of onset,and 12 hours to 24 hours of onset according to the time of usage of batroxobin in the combined group(χ~2=1.568,P>0.05).3.There was no statistically significant difference in efficacy of the combined group whether the infarct site was located in the anterior or posterior circulation according to the responsibility lesions(χ~2=2.511,P>0.05).4.In the combined group,there was 1 case of deterioration(0.63%),1 case of gastrointestinal bleeding(0.63%),and 1 case of death caused by cerebral hemorrhage(0.63%)within six months after discharge.In the control group,there was 1 case of deterioration(0.62%)and 1 case of subconjunctival hemorrhage(0.62%)during the treatment,and no death cases(0.00%)during the six-month follow-up.There was no statistical significance in the probability of adverse events and deterioration in 2groups during treatment(both wereχ~2=0.000,P>0.05).Patients in the two groups were followed up by telephone after discharge from hospital,and the scores were assessed according to the daily living ability of patients,and there was no statistical significance between the two groups(χ~2=1.935,P>0.05).In the combined group,there is one person died six months after discharge from hospital due to hypertensive cerebral hemorrhage,which was not directly related to the application of batroxobin during this hospitalization.Conclusions1.The short-term efficacy of antiplatelet drugs combined with batroxobin in the treatment of acute minor stroke within 24 hours was better than usage of antiplatelet drugs alone,but it did not affect m RS score at three months;2.Treatment with antiplatelet drugs combined with batroxobin within 24 hours of onset of acute minor stroke did not increase bleeding events,and the efficacy was independent of infarct site or the duration of usage.