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Objective@#To explore the clinical benefits and risks of intravenous thrombolysis combined with urinary kallidinogenase in the treatment of minor stroke.@*Methods@#The clinical data of 86 patients with minor stroke were retrospectively analyzed. Patients who received intravenous thrombolysis combined with urinary kallidinogenase were included in observation group (n=48), and those who received intravenous thrombolysis alone were included in control group (n=38). Before treatment and after 2 weeks of treatment, the imaging blood flow perfusion parameters [cerebral blood flow (CBF), mean transit time (MTT), time to peak (TTP)], and breath holding test indexes [cerebral vascular reactivity (CVR), breath holding index (BHI)] and serum biochemical indicators [vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF)] were compared between the two groups. The occurrence of adverse drug reactions during course of treatment and rehabilitation effects at 3 months after treatment [US National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS)] were analyzed in the two groups.@*Results@#After 2 weeks of treatment, the CBF, CVR, BHI and serum levels of VEGF and bFGF in the two groups were significantly higher than those before treatment, and the indexes in observation group were significantly higher than those in control group (P<0.05). The MTT and TTP levels in the two groups were significantly higher than those before treatment, and the levels in observation group were significantly higher than those in control group (P<0.05). There was no significant difference in the incidence rate of adverse drug reactions between the two groups during course of treatment (P>0.05). At 3 months after treatment, there was no statistically significant difference in the effective rate of rehabilitation between the two groups (P>0.05), but the Mann-Whitney U rank sum test between-groups showed that the overall rehabilitation effects in observation group were significantly better than those in control group (P<0.05).@*Conclusions@#Intravenous thrombolysis has certain treatment effects in patients with minor stroke, and its safety is within the clinical controllable range. Combined with urinary kallidinogenase can obtain ideal long-term prognosis, and it is beneficial to the recovery of neurological function.
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Objective To explore the clinical benefits and risks of intravenous thrombolysis combined with urinary kallidinogenase in the treatment of minor stroke.Methods The clinical data of 86 patients with minor stroke were retrospectively analyzed.Patients who received intravenous thrombolysis combined with urinary kallidinogenase were included in observation group (n =48),and those who received intravenous thrombolysis alone were included in control group (n =38).Before treatment and after 2 weeks of treatment,the imaging blood flow perfusion parameters [cerebral blood flow (CBF),mean transit time (MTT),time to peak (TTP)],and breath holding test indexes [cerebral vascular reactivity (CVR),breath holding index (BHI)] and serum biochemical indicators [vascular endothelial growth factor (VEGF),basic fibroblast growth factor (bFGF)] were compared between the two groups.The occurrence of adverse drug reactions during course of treatment and rehabilitation effects at 3 months after treatment [US National Institutes of Health Stroke Scale (NIHSS),modified Rankin Scale (mRS)] were analyzed in the two groups.Results After 2 weeks of treatment,the CBF,CVR,BHI and serum levels of VEGF and bFGF in the two groups were significantly higher than those before treatment,and the indexes in observation group were significantly higher than those in control group (P ＜ 0.05).The MTT and TTP levels in the two groups were significantly higher than those before treatment,and the levels in observation group were significantly higher than those in control group (P ＜ 0.05).There was no significant difference in the incidence rate of adverse drug reactions between the two groups during course of treatment (P ＞ 0.05).At 3 months after treatment,there was no statistically significant difference in the effective rate of rehabilitation between the two groups (P ＞ 0.05),but the Mann-Whitney U rank sum test between-groups showed that the overall rehabilitation effects in observation group were significantly better than those in control group (P ＜ 0.05).Conclusions Intravenous thrombolysis has certain treatment effects in patients with minor stroke,and its safety is within the clinical controllable range.Combined with urinary kallidinogenase can obtain ideal longterm prognosis,and it is beneficial to the recovery of neurological function.
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Objective To analyze the clinical features of elderly patients with acute cerebral infarction with early seizures and pathogenesis mechanisms,clinical therapy and prognosis.Methods The clinical data of 66 cases of elderly patients with acute cerebral infarction complicated with seizures were retrospectively analyzed.Results The analysis found that 66 patients had 2 weeks after the onset of acute cerebral infarction,focal motor seizures in which patients were 37 cases,accounting for 56.1%;generalized tonic-clonic seizures in patients of 21 cases,accounting for 31.8%;bureau focal status epilepticus patients 8 cases,accounting for 12.1%.All patients were 2 to 6 months after treatment withdrawal,and followed up for 5 months,64 patients with no recurrence,2 patients needed long-term medi-cation to control the disease.Conclusion Elderly patients with acute cerebral infarction after seizures need aggres-sive treatment and control of cerebral disease,but patients need to control seizures,which can reduce brain injury,help to improve the prognosis of patients.
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BACKGROUND AND PURPOSE: Dual antiplatelet therapy (DAT) with clopidogrel and aspirin has been shown to confer greater protection against early neurological deterioration (END) and early recurrent ischemic stroke (ERIS) than aspirin alone in patients who have experienced an acute ischemic stroke. However, few studies have compared the effects of anticoagulation therapy with low-molecular-weight heparin (LMWH), DAT, and aspirin. METHODS: Patients with acute ischemic stroke (n=1,467) were randomized to therapy groups receiving aspirin (200 mg daily for 14 days, followed by 100 mg daily for 6 months), DAT (200 mg of aspirin and 75 mg of clopidogrel daily for 14 days, then 100 mg of aspirin daily for 6 months), or LMWH (4,000 antifactor Xa IU of enoxaparin in 0.4 mL subcutaneously twice daily for 14 days, followed by 100 mg of aspirin daily for 6 months). The effects of these treatment strategies on the incidence of END, ERIS, and deep-vein thrombosis (DVT) were observed for 10-14 days after treatment, and their impacts on a good outcome were evaluated at 6 months. RESULTS: The DAT and LMWH were associated with a more significant reduction of END and ERIS within 14 days compared with aspirin-alone therapy. In addition, LMWH was associated with a significantly lower incidence of DVT within 14 days. At 6 months, DAT or LMWH improved the outcome among patients aged >70 years and those with symptomatic stenosis in the posterior circulation or basilar artery compared with aspirin. CONCLUSIONS: LMWH or DAT may be more effective than aspirin alone for reducing the incidence of END and ERIS within 14 days, and is associated with improved outcomes in elderly patients and those with stenosis in the posterior circulation or basilar artery at 6 months poststroke.
Subject(s)
Aged , Humans , Aspirin , Basilar Artery , Constriction, Pathologic , Enoxaparin , Heparin, Low-Molecular-Weight , Incidence , Stroke , Venous ThrombosisABSTRACT
Objective To investigate the interrelations of ALOX5AP SG13S114A/T , COX-2 765G/C , COX-1-50C/T polymorphisms and cerebral infarction. Methods The ALOX5AP SG13S114A/T, COX-2 765G/C and COX-1 50C/T polymorphisms in 411 cases with cerebral infarction and 411 controls were measured by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism method. The generalized multifactor dimensionality reduction (GMDR) method was employed to detect gene-gene interactions. Results Single-gene analysis showed that there were no significant differences in the genotype and allele frequency distributions of ALOX5AP SG13S114A/T, COX-2 765G/C and COX-1 50C/T between two groups. However, in those cases carrying ALOX5AP SG13S114AA as well as COX-2 765CC , the risk of cerebral infarction increased significantly by 2.842 times. Conclusions The combinational analysis among genes used in this study may be helpful in the elucidation of genetic risk factors for common and complex diseases.
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Objective To investigate the incidence of the aspirin resistance in secondary prevention of cerebral infarction, and the relationship between the aspirin resistance and the cerebral infarction recurrence or other vascular events during the follow-up periods.Methods Aspirin were taken from the first day of admission in 600 patients with cerebral infarction.The platelet aggregation rate was measured after 7-10 days to screen the patients with aspirin resistance or aspirin sensitivity.All patients were followed up for 6 to 24 months and the cerebral infarction recurrence and other vascular events were recorded.Logistic regression model was used to estimate the risk factors of aspirin resistance, vascular events and prognosis.Results Of 600 patients, 150 (25.0% ) patients were resistant to aspirin and 450 (75.0% ) patients were sensitive to aspirin.The proportion of female and diabetes patients, and the level of low density lipoproteins (LDL) in the aspirin resistance group were higher than those in the aspirin sensitivity group.Diabetes (OR = 2.58, 95% CI 1.37-4.85, P=0.003) and high LDL level (OR = 1.89, 95% CI 1.21-2.93, P = 0.005 ) were independent risk factors of aspirin resistance.The incidence of cerebral infarction recurrence and myocardial infarction and all-cause mortality in the aspirin resistance group were all higher than those in the aspirin sensitivity group.Diabetes ( OR = 2.47, 95% CI 1.36-4.65, P = 0.003 ) , atherothrombosis cerebral infarction (OR = 2.13, 95% CI 1.24-3.95, P = 0.023) and aspirin resistance (OR = 3.86,95% CI 1.79-5.87, P = 0.002) were independent risk factors of vascular events during the following-up period.In the patients with aspirin resistance, the risk of the recurrence of vascular events increased 3.86 times.Conclusions The incidence of aspirin resistance is high in secondary prevention of cerebral infarction.Aspirin resistance is closely correlated with cerebral infarction recurrence and other vascular events.