Comparative study on the efficacy and safety of alteplase and urokinase in the treatment of acute cerebral infarction

2020 ◽  
pp. 1-6
Author(s):  
Hua Bao ◽  
Hao-Ran Gao ◽  
Min-Lu Pan ◽  
Lei Zhao ◽  
Hai-Bin Sun
Keyword(s):  
Treatment Group ◽  
Cerebral Infarction ◽  
Early Stage ◽  
Intravenous Thrombolysis ◽  
Acute Cerebral Infarction ◽  
Neurological Injury ◽  
Control Group ◽  
Efficacy And Safety ◽  
Time Period ◽  
And Control

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.

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 ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Total Effective Rate ◽  
Intravenous Thrombolysis ◽  
Effective Rate ◽  
Acute Cerebral Infarction ◽  
Inflammatory Factors ◽  
Control Group ◽  
Observation Group ◽  
Efficacy And Safety ◽  
Monocyte Chemoattractant Protein 1

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.

Effect of Argatroban Injection on Clinical Efficacy in Patients with Acute Cerebral Infarction: Preliminary Findings

2021 ◽  
pp. 1-5
Author(s):  
Pan Huang ◽  
Xiao-ying He ◽  
Min Xu
Keyword(s):  
Treatment Group ◽  
Cerebral Infarction ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
National Institutes Of Health ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Scale Scores ◽  
The Difference ◽  
And Control

<b><i>Objective:</i></b> The aim is to observe the effects of argatroban injection and butylphthalide injection on blood flow rheology, clinical efficacy, and safety in patients with acute cerebral infarction. <b><i>Methods:</i></b> 344 patients with acute cerebral infarction within 48 h after admission were divided into treatment group and control group, with 172 cases in each group. The control group received routine treatment. The treatment group received argatroban injection 60 mg on the basis of the control group, intravenously guttae (ivgtt) was used for 2 days and then changed to argatroban injection 10 mg, ivgtt bid for 5 days, and the total course of treatment was 7 days. The neurological changes, activities of daily living, and the rheology indicators (fibrinogen [Fib], platelet aggregation rate [Pag], whole blood high shear viscosity [Whsv], hematocrit [Hct]) were compared between the 2 groups, clinical efficacy and adverse drug reactions. <b><i>Results:</i></b> After treatment, the total effective rates of the treatment group and the control group were 90.70% (156 /172 cases) and 74.41% (128 and 172 cases), respectively, and the difference was statistically significant (<i>p</i> &#x3c; 0.05). After treatment, the National Institutes of Health Stroke Scale scores of the treatment group and the control group were (7.05 ± 1.97) and (8.30 ± 1.79), respectively, and the Barthel index was (68.02 ± 11.07) and (62.32 ± 11.46), respectively. The difference was statistically significant (<i>p</i> &#x3c; 0.05). After treatment, the treatment group and the control group were (2.66 ± 0.22) g/L and (3.50 ± 0.22) g/L, respectively, and Pag were (0.68 ± 0.06)% and (0.81 ± 0.09)%, respectively, and Whsv was (6.44 ± 0.76) mPs/s and (6.87 ± 0.91) mPs/s, Hct were (8.19 ± 1.21)% and (10.44 ± 1.04)%, respectively, and the differences were statistically significant (<i>p</i> &#x3c; 0.05). The incidence of adverse reactions in the treatment group and the control group was 6.97 and 5.81%, respectively, and the difference was not statistically significant (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Argatroban injection is effective in the treatment of acute cerebral infarction, which can significantly improve the hemorheology of patients with good safety.

scholarly journals Intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Xiaoying Liu ◽  
Shengli Rao ◽  
Jiajia Wang
Keyword(s):  
Cerebral Infarction ◽  
Conventional Treatment ◽  
Mild Hypothermia ◽  
Intravenous Thrombolysis ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Observation Group ◽  
Nihss Score ◽  
Time Points ◽  
Before And After

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.

scholarly journals Effects of Intravenous Thrombolytic Therapy with Alteplase on Neurological Function, Coagulation Function and Serum Inflammatory Factors in Patients with Acute Cerebral Infarction

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Xianfang Yue ◽  
Hua Zhou
Keyword(s):  
Cerebral Infarction ◽  
Intravenous Thrombolysis ◽  
Neurological Function ◽  
Acute Cerebral Infarction ◽  
Inflammatory Factors ◽  
Control Group ◽  
Routine Treatment ◽  
Coagulation Function ◽  
Hs Crp ◽  
Thrombolysis Therapy

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.

scholarly journals Clinical Effect of Ozagrel Sodium Combined with Eureklin on Acute Cerebral Infarction

2021 ◽  
Vol 233 ◽  
pp. 02025
Author(s):  
Shen Shiheng ◽  
Yan Shaoxiong
Keyword(s):  
Cerebral Infarction ◽  
Clinical Effect ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Cerebrovascular Event ◽  
Human Society ◽  
Observation Group ◽  
Disability Rate ◽  
And Control ◽  
Very High

Cerebral infarction, as a serious cerebrovascular event, can lead to symptoms of various neurological disorders. The disability rate, mortality rate and recurrence rate are also very high, which is the health and economic burden of individuals, families and even human society. In this paper, 60 patients with cerebral infarction treated in our hospital were divided into observation group and control group. The observation group was treated with Ozagrel sodium combined with Eureklin, and the control group was given a single Ozagrel regimen The results showed that Ozagrel sodium combined with Yuclin was effective in the treatment of acute cerebral infarction.

scholarly journals Clinical Study of MEBO Combined with Jinhuang Powder for Diabetic Foot with Infection

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Hong-Bo Zhan ◽  
Qing-Qing Sun ◽  
Lei Yan ◽  
Jia Cai
Keyword(s):  
Wound Healing ◽  
Clinical Study ◽  
Treatment Group ◽  
Diabetic Foot ◽  
Effective Rate ◽  
Control Group ◽  
Efficacy And Safety ◽  
Wound Pain ◽  
The Difference ◽  
And Control

Background. To investigate the efficacy and safety of MEBO combined with Jinhuang powder for the treatment of diabetic foot with infection. Methods. From August 2015 to August 2019, patients with diabetic foot in our hospital were divided into the treatment group and control group. The treatment group was treated with moist exposed burn ointment (MEBO) combined with Jinhuang powder, while the control group was treated with MEBO only. Results. After one week of treatment, the effective rate in the treatment group was 100%, and the effective rate in the control group was only 76%. The difference between the two groups was statistically significant ( P < 0.05 ). The wound pain score was 2.40 ± 1.38 in the treatment group and 3.76 ± 1.85 in the control group. The difference was statistically significant ( P < 0.01 ). After one month of treatment, the effective rate of wound healing was 92.0% in the treatment group and 68% in the control group. The difference between the two groups was statistically significant ( P < 0.05 ). Conclusion. MEBO combined with Jinhuang powder is effective in treating diabetic foot with infection wound.

Donepezil Improves Gait Performance in Patients with an Acute Cerebral Infarction: A Prospective Observational Cohort Study

2020 ◽  
Vol 17 (3) ◽  
pp. 304-311 ◽  
Author(s):  
Ying-Ying Lin ◽  
Shi-Jie Guo ◽  
Hui Quan ◽  
Yan-Xin Zhao ◽  
Dong-Ya Huang
Keyword(s):  
Risk Factors ◽  
Cerebral Infarction ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Observation Group ◽  
Gait Performance ◽  
Nihss Score ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
And Control

Background: Hemiplegia is a common symptom after acute cerebral infarction. Objective: This study aimed to explore the influence factors of gait performance and investigate whether donepezil could improve gait performance in patients with an acute cerebral infarction. Methods: A total of 107 patients who experienced unilateral paresis after an acute cerebral infarction incident were enrolled in this prospectively observational study. Participants underwent a 3- month assessment. At the study's conclusion, patients were divided into 2 groups-those who received donepezil daily (observation Group) and those who did not (Control Group). Results: There was a significant difference (t=3.269, P=0.001) of Wisconsin Gait Scale (WGS) score between single site infarction (27.11±6.65) and multiple sites infarction (31.54±6.42). For gender, smoking, drinking, hypertension, hyperlipidemia and diabetes, there was no difference in WGS scores between subgroups (P>0.05), respectively. The patient's admission National Institute of Health Stroke Scale(NIHSS) score had a strongly positive correlation with WGS score (r=0.850, P<0.001). Besides, age (r=0.218, P=0.024), glycosylated hemoglobin (r=0.274, P=0.004), MMSE (r=-0.261, P=0.007) and Montreal Cognitive Assessment (MoCA) (r=-0.272, P=0.005) had a weak correlation with WGS scores. Multivariate analysis showed age (95% CI: 0.042~0.188, P=0.002), admission NIHSS score (95% CI: 2.405~3.137, P<0.001) and multiple sites infarction (95% CI: 0.044~2.983, P=0.044) were independent risk factors of WGS scores. WGS scores of both observation and control groups gradually decreased after admission (P<0.001). At 3 months after admission, WGS score of the observation group was significantly lower than the control group (t=2.468, P=0.015). There were no significant differences between observation and control group at admission and 1 month after admission (P>0.05) and WGS scores of both single site and multiple sites infarction gradually decreased at one month and three months after admission (P<0.001), while there was no significant difference between two groups (P>0.05). Conclusion: Admission NIHSS score, age and multiple sites infarction were independent risk factors of WGS score. Donepezil could improve gait performance in patients with acute cerebral infarction.

scholarly journals The Value of Safflower Yellow Injection for the Treatment of Acute Cerebral Infarction: A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Le-Jun Li ◽  
Yu-Mei Li ◽  
Ben-Yu Qiao ◽  
Shan Jiang ◽  
Xin Li ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Controlled Trial ◽  
Interleukin 1 ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
Once Daily ◽  
Rbc Aggregation ◽  
Factor Alpha ◽  
And Control

Background. Safflower Yellow Injection has been reported as a treatment for acute cerebral infarction in recent studies in China. However, there is a lack of availability of the evidence for the efficacy and safety of Safflower Yellow Injection for the treatment of acute ischemic stroke. So we investigated the effects of Safflower Yellow Injection for the treatment of acute cerebral infarction.Method. All subjects were randomly divided into Safflower Yellow Injection group given Safflower Yellow Injection (80 mg) and control group given placebo (0 mg) injection by intravenous drop once daily for 14 days. National Institute of Health Stroke Scale (NIHSS); hemorheological detection; coagulation function; and serum inflammatory markers, tumor necrosis factor-alpha (TNF-α), interleukin-1β(IL-1β), and interleukin-6 (IL-6), were used to investigate the effects before and 14 days after the treatment.Results. The scores of NIHSS were decreased on day 7 and day 14 after treatment. The hemorheological index of RBC deformation and RBC aggregation were significantly improved, prothrombin time (PT) increased, and fibrinogen (FIB) and TNF-α, IL-1β, and IL-6 were decreased in patients treated with Safflower Yellow injection on day 14 after treatment (P<0.05).Conclusion. Data suggests that Safflower Yellow Injection therapy may be beneficial for acute cerebral infarction.

scholarly journals Clinical Study of Urinary Kallidinogenase in the Treatment of Progressive Cerebral Infarction

2013 ◽  
Vol 2 ◽  
pp. 13
Author(s):  
Binghui Fan ◽  
Weidong Li
Keyword(s):  
Treatment Group ◽  
Cerebral Infarction ◽  
Adverse Reactions ◽  
Total Effective Rate ◽  
Neurological Impairment ◽  
Effective Rate ◽  
Control Group ◽  
Before And After ◽  
And Control ◽  
Better Than

<p><strong>Objective: </strong>To evaluate the efficacy and safety of Urinary kallidinogenase in the treatment of progressive cerebral infarction. <strong>Method: </strong>104 cases of patients with acute cerebral infarction were randomly divided into treatment group and control group; where control group (52 cases) patients on with only basic medicine, while treatment group (52 cases), besides the basic medicine, patients will on urinary kallidinogenase 0.15 PNAU + 0.9% normal saline 100 mL intravenous injection, 1 times per day, and continuous for 14 days. The degree of neurological impairment (NIHSS) was assessed before and after treatment, and the changes of blood pressure were monitored. The liver, renal function, fibrinogen, platelet, and the adverse reactions were recorded and followed up in three month. <strong>Results</strong><strong>: </strong>After treatment, NIHSS scores of the both groups were decreased (<em>p</em> &lt; 0.05), however, total effective rate for treatment group were better than control group (<em>p</em> &lt; 0.05). <strong>Conclusion: </strong>Urinary kallidinogenase is safe and effective in the treatment of progressive cerebral infarction.</p>

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