Statistical analysis for efficacy of tirofiban combined with ozagrel in the treatment of progressive cerebral infarction patients out of thrombolytic therapy time window

OBJECTIVES: To investigate the safety and efficacy of combined tirofiban-ozagrel therapy for treating progressive stroke patients out of thrombolytic therapy time window. METHODS: This prospective, double-blind, randomized controlled study included 337 patients who had experienced an acute ischemic stroke between November 2017 and December 2018. All patients were randomized into three groups: 1) the tirofiban/ozagrel group (n=113), 2) the tirofiban group (n=110), and 3) the ozagrel group (n=114). The platelet aggregation (PAG), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen (FIB) levels in the patients from these groups were evaluated before starting treatment and then, at 24h, 7 days, and 14 days after treatment. The National Institutes of Health Stroke Scale (NIHSS) scores were evaluated before treatment and then, 24h, 1 week, 2 weeks, and 4 weeks after treatment. The Barthel Index (BI) score was used to measure safety, and the modified Rankin scale (mRS) was used to evaluate disability following 3 months of treatment. The risk factors affecting clinical outcomes were analyzed using logistic multivariate regression. RESULTS: The mean NIHSS score for all the patients was 13.17±3.13 before treatment, and no significant difference between the basic clinical parameters of the three patient groups was found. Following treatment, both PAG and FIB were significantly reduced compared with the baseline (p<0.05). The levels of PAG and FIB in the tirofiban/ozagrel group were significantly lower than those in the tirofiban and ozagrel groups at 24h and 7 days after treatment (p<0.05). The NIHSS score decreased significantly in all treatment groups (p<0.05). The tirofiban/ozagrel NIHSS scores were significantly lower than that of the tirofiban and ozagrel groups at 24h, 1 week, and 2 weeks post initiation (p<0.05 for all). There were no significant differences in the BI and mRS scores or the intracranial hemorrhage rates; further, age, sex, Trial of ORG 10172 in acute stroke treatment (TOAST) type, baseline NIHSS and 24-h NIHSS scores, baseline thrombus-related factors, and treatment methods were shown to not be independent risk factors for clinical outcomes. CONCLUSION: The combination of tirofiban and ozagrel, as well as monotherapy with either tirofiban or ozagrel, transiently improves the neural function of patients and reduces platelet aggregation and fibrinogen formation in the first 4 weeks following a stroke event; additionally, none of these treatments increased the risk for hemorrhage in these progressive stroke patients over a 3-month period.

Clinical significance and changes of inflammatory cytokines in patients suffered from progressive cerebral ;infarction / 中国基层医药

Objective To observe and analyze the changes of inflammatory cytokines levels in patients with progressive cerebral infarction (PCI ).Methods The patients with progressive cerebral infarction (progressive cerebral infarction group),the patients with non-progressive cerebral infarction(non progressive cerebral infarction group)and the healthy individuals(control group)were selected as the research subjects.Sixty individuals were included in each group.The levels of IL-8,hs -CRP,SAA of the research subjects were detected and observed. Results The levels of IL -8[(201.89 ±46.41)mg/L],hs -CRP[(16.55 ±4.49)mg/L],SAA[(20.65 ± 4.17 )mg/L]of the progressive cerebral infarction group were significantly higher than those of non -progressive cerebral infarction group[(132.02 ±40.26 )mg/L,(8.09 ±4.06)mg/L and (15.35 ±4.07 )mg/L).]The differ-ences were statistically significant (t=4.289,P=0.000;t=2.276,P=0.006 and t=2.269,P=0.031).Compared with the control group[(50.70 ±31.14 )mg/L,(0.70 ±0.11 )mg/L and (5.15 ±2.21)mg/L],the levels of IL-8, hs-CRP,SAA in the progressive cerebral infarction group and non -progressive cerebral infarction group were significantly higher on the first day (PCI group vs control:t=3.614,P=0.000;t=3.406,P=0.007;t=2.559, P=0.009;NPCI group vs control:t=3.602,P=0.000;t=3.181,P=0.009;t=1.520,P=0.026).Conclusion The changes of the inflammatory factors levels such as IL-8,hs-CRP,SAA have certain predicative value on the development of the PCI.

Research on effects of argatroban combined with Kallikrein on progressive cerebral infarction / 中国医学装备

Objective:To explore the effect of argatroban combined with Kallikrein on progressive cerebral infarction.Methods: One hundred and fifty two progressive cerebral infarction patients were randomized into groups observation (n=76) and control (n=76). Observation group were given treatment ofargatroban and Kallikrein, control only Kallikrein. NIHSS scores, Barthel index, Modified Rankin Scales(MRS) were used to evaluate the efficacy in two groups.Results: The difference of the effect was significant in two groups(x2=11.463,P>0.05).In both of the two groups, NIHSS scores were decreased, there was significant difference between the two groups (t=1.501,t=1.844,t=1.341;P<0.05). The Barthel index in argatroban combined Kallikrein group was higher than Kallikrein group, Modified Rankin Scales was lower than Kallikrein group, and there was significant difference between the two groups (t=2.121,t=2.332,t=2.219;P<0.05). The observation group and the control group patients don''t have bleeding gums,subcutaneous bleeding, gastrointestinal bleeding and other adverse reactions.Conclusion: Argatroban combined with Kallikrein, improve the neurologic impairment symptoms, clinical effect, improve the life quality of the patients, of a relatively good effect in treatment of progressive cerebral infarction, can improve obviously the cognitive ability and neural function and patients, activities of daily living. Moreover, its security and tolerability are good.

The role of imaging features of cerebral infarction in predicting the progressive cerebral infarction / 中国神经精神疾病杂志

Objective To investigate the role of imaging characteristics of cerebral infarction in different regions in predicting the progressive cerebral infarction (PCI). Methods Patients with cerebral infarction were selected in the De?partment of Neurology of Hefei third People’s Hospital from January 2010 to June 2014. Brain MRI were examined the location of cerebral infarction. Patients were then classified into four groups accordingly:cortical infarction, basal gangli?on infarction, coronaradiata infarction and posterior infarction. Patients were further divided into PCI group and non-PCI group according to their clinical manifestations. MRI imaging features and risk factors were analyzed and compared be?tween PCI group and non-PCI group. Results A total of 150 patients with cerebral infarction were enrolled, including 99 cases of non-PCI and 51 cases of PCI. According to the Brain imaging classification, there were 46 cases of cortical in?farction, 25 cases of coronaradiata infarction, 47 cases of basal ganglion infarction and 32 cases of posterior infarction. There were significant differences in subtype cerebral infarction between PCI group and non-PCI group(χ2=19.239,P= 0.001). The percent of cortical infarction were significantly higher in PCI group compared to the non-PCI group. Cortical infarction was correlated to PCI and the value of R and P was 0.170 and 0.026, respectively. Logistic regression revealed that Imaging of subtypes of cerebral infarction was correlative with PCI (P=0.002). The frequency of progression was sig?nificantly increased in cortical infarction than in other subtypes of cerebral infarction (P=0.002). The trend was still sig?nificant even after adjustment for age and blood glucose, (P=0.014). Conclusion The location of cerebral infarction is closely correlated to PCI in which cortical infarction is more likely to develop PCI.

Impact of Butylphthalide on Homocysteine, CRP and Nerve Function in Patients with Acute Progressive Cerebral Infarction / 中国药师

Objective:To investigate the impact of butylphthalide on homocysteine, CRP and nerve function in the patients with a-cute progressive cerebral infarction. Methods:Totally 122 cases of patients with acute cerebral infarction were randomly divided into the observation group (n=60) and the control group (n=62). The control group was treated with the routine treatment, and the ob-servation group was treated with butylphthalide additionally. The treatment course was two weeks. The total effective rate, blood Hcy, the level of plasma CRP and the changes of neurological function deficits scale in both groups before and after the treatment were ob-served and compared. Results:The overall response rate in the observation group (81. 67%) was significantly higher than that in the control group (64. 52%). After the treatment, the blood Hcy and CRP in both groups were significantly lower than that before the treatment(P<0. 05), and that of the observation group was significantly lower than that of the control group(P<0. 05). The neuro-logical function deficits scale in both groups were significantly lower than that before the treatment(P<0. 05), and that of the observa-tion group was significantly lower than that of the control group at the same period. The two groups during the treatment showed no sig-nificant adverse reactions. Conclusion: The effect of butylphthalide in the patients with acute cerebral infarction is effective, which can reduce blood Hcy, the level of plasma CRP and the neurological function deficits scale, and improve the neurological function with-out obvious adverse reactions during the treatment course.

Observation of effects of the brain-located mild hypothermia therapy on acute progressive cerebral infarction / 中国康复理论与实践

@#ObjectiveTo study effects of treating acute progressive cerebral infarction by the brain-located mild hypothermia therapy.Methods60 patients were randomly divided into the treatment group (30 cases) and the control group (30 cases). Drugs were used in both groups, and the located mild hypothermia therapy was only applied in the treatment group. After 72 hours and 7 days, the volume of cerebral infarction and the nerve function deficiency (NFD) scores of hemiplegic limbs were compared.ResultsThe volume of cerebral infarction of the treatment group was significantly smaller than that of the control group (P<0.01).There were significant differences on the neurological impairment scores between two groups (P<0.01).Conclusions The brain-located mild hypothermia therapy can reduce hydrocephalus of patients with acute progressive cerebral infarction, and have brain protection. These results provide an important theoretical foundation for the treatment of cerebral infraction with low-temperature therapy.

Curative effects observation of treatment with Plaix and Aspirine for patients with progressive cerebral infarction / 临床神经病学杂志

Objective Investigate the efficacy of Plaix and Aspirine on treating the patients with progressive cerebral infarction.Methods 92 patients with progressive cerebral infarction were randomly divided into unite therapy group(n=46) and control groups(n=46).Two groups were taken the conventional therapy.In the patients of unite therapy group,oral Plaix 75 mg and Aspirine 150 mg per day,control group oral Aspirine 150 mg per day.Clinical neural deficiency score(NDS) was given before and 30 d after treatment for comparison and measur blood solidifying function and Heraorheological indexes.Results Total effective rate in the unite therapy group(93%)was significant higher than that in the control group(74%)(P

Changes and significance of levels of serum C-reactive protein and S-100? protein in patients with progressive cerebral infarction / 临床神经病学杂志

Objective To investigate the changes and significance of the levels of serum C-reactive protein(CRP) and S-100? protein(S-100?)in patients with progressive cerebral infarction(PCI).Methods 100 acute cerebral infarction(ACI) patients were divided into PCI group(38 cases) and non-PCI group(62 cases) according to the change of the neurological dysfunction scale score(SSS) within 7 d after onset.The levels of serum CRP and S-100? in the two groups were detected at the 1 d,3 d,7 d,14 d after onset,and the results were compared with normal controls(NC group).Results Compared with the non-PCI group,the levels of serum CRP and S-100? in the PCI group at every time points after onset were significantly increased(all P

Curative effects of Edaravone combined Batroxobin on treating progressive cerebral infarction / 临床神经病学杂志

Objective To observe the curative effects of Edaravone combined Batroxobin on treating pro-gressive cerebral infarction(PCI).Methods 50 patients with PCI were treated with Edaravone 30 mg intravenous drip twice a day for 14 d.Meanwhile,Batroxobin 10 BU on the first day,subsequently 5 BU intravenous drip,once for next day,total 4 times.European stroke scale(ESS),Barthel index and plasma fibrinogen(Fib) level were tested before and after treatment.Compared with the patients(control group) treated with Batroxobin only.Results The score of ESS in united treatment group on 7th,14th,21th day were obviously higher than those in the control group(all P