scholarly journals Intravenous thrombolysis with alteplase in the treatment of acute cerebral infarction

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Lilin Gao ◽  
Shaojie Zhang ◽  
Xuewen Wo ◽  
Xiangpeng Shen ◽  
Qiangyuan Tian ◽  
...  

Objectives: To compare the efficacy and safety of intravenous thrombolysis with alteplase and intravenous thrombolysis with urokinase for patients with acute cerebral infarction. Methods: This prospective study included 140 patients with acute cerebral infarction who were admitted to our hospital between June 2018 and June 2019. They were randomly divided into two groups. The control group (70 cases) was treated with urokinase intravenous thrombolysis, and the observation group (70 cases) was given alteplase intravenous thrombolytic therapy. The treatment efficacy and safety of the two groups were compared. Results: The total effective rate of the observation group was 95.7%, and that of the control group was 78.6%, i.e., the total effective rate of the observation group was significantly superior to the that of the control group (P < 0.05). After treatment, the observation group had significantly lower National Institutes of Health Stroke Scale (NIHSS) score and significantly higher mini-mental state examination (MMSE) score than the control group; the difference was statistically significant (P<0.05). After treatment, the levels of inflammatory factors of both groups significantly decreased compared to before treatment, and the decrease in the observation group was larger than that in the control group (P<0.05). The levels of serum homocysteine (Hcy) and monocyte chemoattractant protein-1 (MCP-1) in the observation group were significantly lower than those in the control group after treatment, and the differences were statistically significant (P<0.05). The incidence of hemorrhagic adverse reaction in the observation group was lower than that in the control group (P<0.05). Conclusion: In the treatment of acute cerebral infarction, ccompared with urokinase, alteplase can further relieve cognitive impairment and promote the recovery of nerve function through inhibiting levels of inflammatory factors and levels of serum Hcy and MCP-1. doi: https://doi.org/10.12669/pjms.38.3.4521 How to cite this:Gao L, Zhang S, Wo X, Shen X, Tian Q, Wang G. Intravenous thrombolysis with alteplase in the treatment of acute cerebral infarction. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4521 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

2020 ◽  
pp. 1-6
Author(s):  
Hua Bao ◽  
Hao-Ran Gao ◽  
Min-Lu Pan ◽  
Lei Zhao ◽  
Hai-Bin Sun

BACKGROUND: Acute cerebral infarction (ACI) is a common cerebrovascular disease in clinical practice. OBJECTIVE: The present study aims to investigate the efficacy and safety of alteplase and urokinase in treating ACI. METHODS: A total of 96 patients with ACI, who were treated with alteplase and urokinase, were selected as the main subjects. Among these patients, 45 patients with ultra-early acute cerebral infarction, who received intravenous thrombolysis with RT-PA (alteplase), were included in the treatment group, while 51 patients with acute cerebral infarction, who were treated with urokinase in the same time period, were included in the control group. RESULTS: The National Institute of Health Stroke Scale (NIHSS) scores were significantly lower in the treatment group and control group (P< 0.05) at two hours, seven days and 14 days after thrombolysis, when compared to those before thrombolysis. The bleeding rate was significantly lower in the control group, when compared to the treatment group (P< 0.05). CONCLUSION: The intravenous thrombolysis with urokinase or alteplase in the ultra-early stage of acute cerebral infarction can reduce the neurological injury symptoms and effectively improve the prognosis of patients with stroke. Urokinase is lower in risk of bleeding, but better in safety, when compared to alteplase.


2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Xiaoying Liu ◽  
Shengli Rao ◽  
Jiajia Wang

Objective: To investigate the efficacy of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction. Methods: One hundred and thirty-two patients with acute cerebral infarction who were admitted to our hospital were selected and grouped into a control group and an observation group, 66 each group. Patients in the control group were given conventional treatment in combination with local mild hypothermia therapy, and patients in the observation group were given rt-PA intravenous thrombolysis on the basis of conventional treatment and local mild hypothermia therapy. National institute of health stroke scale (NIHSS) score and intracranial pressure (ICP) of the two groups before and after treatment was recorded. The efficacy of the two groups was evaluated. The modified Rankin scale (MRS) score was followed up for three months. The blood samples of the patients were collected before and after thrombolysis. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels in the plasma were detected. Results: The NIHSS score of the two groups decreased in the 1st, 3rd and 7th day after treatment compared to before treatment (p<0.05), but the NIHSS score of the two groups had no significant difference at different time points after treatment (p>0.05). The ICP of the two groups decreased in the 1st, 3rd and 7th day after treatment compared to before treatment (p<0.05), and the decrease of ICP of the observation group was more significant than that of the control group at the same time point (1st, 3rd and 7th day after treatment) (p<0.05). The clinical efficacy of the observation group was higher than that of the control group after treatment, and the difference was statistically significant (p<0.05). The MDA concentration of both groups decreased at different time points after treatment (p<0.05), but the SOD concentration increased (p<0.05). The MDA concentration of the observation group was lower than that of the control group at different time points after treatment (p<0.05), and the SOD concentration of the observation group was higher than that of the control group (p<0.05). Conclusion: rt-PA intravenous thrombolysis in combination with mild hypothermia therapy has significant efficacy in the treatment of acute cerebral infarction. It can effectively relieve neurological function. Its action mechanism may be realized by relieving oxidative stress response. doi: https://doi.org/10.12669/pjms.35.4.311 How to cite this:Liu X, Rao S, Wang J. Intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction. Pak J Med Sci. 2019;35(4):1161-1166. doi: https://doi.org/10.12669/pjms.35.4.311 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Xianfang Yue ◽  
Hua Zhou

Objective: To investigate the effects of intravenous thrombolysis therapy with alteplase on neurological function, coagulation function and serum inflammatory factors in patients with acute cerebral infarction. Methods: A total of 96 patients with acute cerebral infarction admitted to our hospital from September 2017 to October 2019 were randomly divided into two groups, with 48 patients in each group. The control group (n=48) received routine treatment, and the observation group received intravenous thrombolysis therapy with alteplase on the basis of routine treatment. The neurological deficit score, prothrombin time(PT), activated partial thromboplastin time (APTT), tumor necrosis factor-a level (TNF-?), and high-sensitivity C-reactive protein (hs-CRP) were compared between the two groups after 15 days of treatment. Results: After treatment, NIHSS scores in both groups were lower than those before treatment; PT levels were increased, while APTT, TNF-? and hs-CRP levels were all decreased in both groups, and the changes in the observation group were greater than those in the control group, with statistically significant difference (P<0.05). Conclusions: Intravenous thrombolysis therapy with alteplase can improve the neurological function, coagulation function and serum levels of inflammatory factors in patients with acute cerebral infarction, which is worthy of clinical application.


2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Shaojie Zhang ◽  
Lilin Gao ◽  
Xuewen Wo ◽  
Zhonggong Wang

Objectives: To investigate the clinical effect of mild hypothermia combined with intravenous thrombolysis in the treatment of acute cerebral infarction. Methods: Eighty-eight patients with acute cerebral infarction in Binzhou People’s Hospital between May 2018 and August 2019 were randomly selected and divided into a control group and an observation group according to the random number table method, with 44 patients in each group. The control group was given intravenous thrombolysis; the observation group was treated with mild hypothermia (30-350C) in addition to intravenous thrombolytic thrombolysis. The clinical efficacy, incidence of complications, oxidative stress indexes, inflammatory factor level, neurological function, and mental state of the two groups before and after treatment were compared. Results: The clinical efficacy of the observation group was significantly better than that of the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the levels of oxidative stress indexes and inflammatory factors between the two groups before treatment (P<0.05). After treatment, the levels of oxidative stress indexes and inflammatory factors of the two groups significantly improved, and the improvement of the observation group was better than that of the control group; the differences were statistically significant (P<0.05). There was no significant difference in the neurological function and mental state between the two groups before treatment (P<0.05). After treatment, the neurological function and mental state of the two groups significantly improved, and the improvement of the observation group was better than that of the control group; the differences were statistically significant (P<0.05). There was no significant difference in the incidence of complications and mortality between the two groups (P>0.05). Conclusion: Thrombolytic therapy combined with mild hypothermia has a good efficacy in the treatment of acute cerebral infarction. The therapy can improve the neurological function of patients with acute cerebral infarction by significantly improving the oxidative stress index and relieving the inflammatory reaction. Its efficacy is better than single thrombolytic therapy. doi: https://doi.org/10.12669/pjms.37.7.4499 How to cite this:Zhang S, Gao L, Wo X, Wang Z. Clinical observation of mild hypothermia combined with intravenous thrombolysis in treating patients with acute cerebral infarction. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4499 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Xuewen Wo ◽  
Jinyan Han ◽  
Jiajia Wang ◽  
Xinmin Wang ◽  
Xiaoying Liu ◽  
...  

Objective: To observe the clinical efficacy of sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of elderly patients with acute cerebral infarction (ACI). Methods: One hundred and twenty-two elderly patients with ACI who were admitted to the department of neurology of our hospital at May 2016-August 2018 were selected grouped into a control group and an observation group by random number table method, 61 in each group. On the basis of conventional treatment, the patients in the control group were given dual antiplatelet therapy (aspirin enteric-coated tablets + clopidogrel bisulfate tablets), while the patients in the observation group were given sequential butylphthalide therapy on the basis of the control group. The clinical effects of the two groups were compared after four weeks of treatment, and the changes of National Institutes of Health Stroke Scale (NIHSS), ADL score, plasma 3-mercaptopyruvate sulphurtransferase (3-MST) and Amyloid β42 (Aβ42) levels and the occurrence of adverse reactions during treatment were recorded. Results: The clinical efficacy of the observation group was better than that of the control group (P<0.05). There was no significant difference in NIHSS and ADL scores between the two groups before treatment (P>0.05). After treatment, the NIHSS and ADL scores of the observation group were better than those of the control group (P<0.05). There was no significant difference in plasma levels of 3-MST and AB42 between the two groups before treatment (P>0.05). The level of plasma 3-MST in the observation group was higher than that in the control group, and the level of plasma Aβ42 was lower than that in the control group (P<0.05). No serious adverse reactions occurred during the treatment period in both groups. Conclusion: Butylphthalide sequential therapy combined with dual antiplatelet therapy is effective in the treatment of elderly ACI. It can effectively improve the plasma level of 3-MST and decrease the plasma level of Aβ42, which is conducive to improving the living ability and neurological function of patients and has high safety. doi: https://doi.org/10.12669/pjms.36.4.1831 How to cite this:Wo X, Han J, Wang J, Wang X, Liu X, Wang Z. Sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of acute cerebral infarction. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1831 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Yun Zhang ◽  
Yuying Lan

Objective: To discuss the specific application of Zhuang Medicine Crystal Sugar Ye’An Decoction in senile skin pruritus and its effects on serum IgE detection level. Methods: 90 patients with senile skin pruritus admitted to our hospital from February 2019 to April 2020 were randomly grouped. The general treatment effect, itching, secondary skin lesion severity, serum IL-6, IgE level and adverse reactions between 45 patients treated with Chlorcyclizine Hydrochloride Tablets (The control group) and 45 patients treated with Crystal Sugar Ye’An Decoction were compared. Results: The total effective rate of the treatment in the observation group was 93.33%, much higher than that in the control group, 75.56%. The difference was verified and statistically significant (P<0.05). Before the treatment, the itching area, frequency, duration and severity of secondary skin lesions were at the same level (P>0.05). After the treatment, the above data were all reduced, and the reduction of the observation group was more significant than that of the control group, indicating the difference was statistically significant (P<0.05). Before the treatment, there was no difference in serum IL-6 and IgE test data between the two groups (P>0.05). After the treatment, the tendency all declined, and that of the observation group was more obvious, indicating the difference was statistically significant (P<0.05). During the experiment, no obvious adverse reactions were observed in both groups. Conclusion: In the treatment of patients with senile pruritus, the application of Zhuang Medicine Crystal Sugar Ye’An Decoction is not only safe and reliable, but can promote the improvement of patients’ symptoms, adjust the level of inflammatory factors, and enhance clinical efficacy.


2021 ◽  
Vol 7 (5) ◽  
pp. 3384-3388
Author(s):  
Wei Sun ◽  
Wenjie Yu ◽  
Yanhua Wang ◽  
Guangliang Hu

Objective: The clinical effect of arthroscopic debridement combined with rehabilitation training in the treatment of knee arthritis was studied and analyzed. Methods: A total of 90 patients with knee osteoarthritis treated in our hospital from August 2017 to August 2018 were selected as the research objects. All patients were divided into the observation group and the control group by using the random number method. The control group was treated by arthroscopic cleaning operation, and the observation group was treated by combined rehabilitation training on the basis of the treatment in the control group. The total effective rate and simple McGill pain of the two groups were compared Score and lyshoim score. Result: The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05), the difference was statistically significant; after treatment, the simple McGill pain score of the observation group was significantly lower than that of the control group (P < 0.05), the difference was statistically significant, the lyshoim score of the observation group was significantly better than that of the control group (P < 0.05), the difference was statistically significant. Conclusion: In the treatment of knee osteoarthritis, arthroscopic debridement combined with rehabilitation training has a significant effect, which can significantly reduce the pain and improve the prognosis of patients. It is worth popularizing in clinical treatment.


Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Xu-qiang Huang ◽  
Li Deng ◽  
Gen Lu ◽  
Chun-hui He ◽  
Pei-qiong Wu ◽  
...  

Abstract To observe a therapeutic effect of macrolide antibiotics in children with Pseudomonas aeruginosa pneumonia. Fifty-four cases of children with Pseudomonas aeruginosa pneumonia were randomly divided into an observation group (n=30) and a control group (n=24). The observation group was treated with macrolide antibiotics and cefoperazone/sulbactam. The control group was treated with cefoperazone/ sulbactam during a course of 10-14 days. The total effective rate was 93.3% in the observation group, and 58.3% in the control group, and results in the observation group were superior to the control group notably (P>0.05). There were no significant differences in bacterial clearance rate, adverse reaction rate between two groups (P>0.05). The combined application of cefoperazone/sulbactam with macrolide antibiotics to treat Pseudomonas aeruginosa pneumonia in children would be a more effective clinical method.


2013 ◽  
Vol 2 ◽  
pp. 7
Author(s):  
Li Liu

<p><strong>Objective: </strong>To study the clinical effect on the treatment of cardiac arrhythmia, and further guide the clinical treatment. <strong>Method: </strong>From January 2011 to January 2013, 100 patients with arrhythmia were randomly divided into observation group and control group with 50 cases in each group. Observation group patients given oral Stable heart granule treatment, while control group was treated with oral propafenone treatment. The therapeutic effect and adverse reactions of the two groups were observed and compared. <strong>Results: </strong>The total effective rate of the observation group was higher than control group and incidence of adverse reactions was lower than control group, the difference was statistically significant, <em>p</em> &lt; 0.05. The use of stable heart particles in the treatment of arrhythmia produce significant effect. <strong>Conclusion: </strong>Clinical effect for Stable heart granule on arrhythmia was significant and should widely entrenched in clinical practice.</p>


Sign in / Sign up

Export Citation Format

Share Document