Objective To investigate the influence factors of re-occlusion after intravenous thrombolysis of alteplase in patients with cerebral infarction and the therapeutic effect of tirofiban.
Methods A total of 100 patients with cerebral infarction were selected as the study objects. The patients were divided into occlusion group (n=42) and non-occlusion group (n=58) according to whether re-occlusion after intravenous thrombolysis with alteplase. The occlusion group was given tirofiban treatment. General data were compared between two groups. Logistic regression model was used to analyze the influencing factors of re-occlusion after alteplase intravenous thrombolysis in patients with cerebral infarction. The total effective rate, recombinant human tissue plasminogen activator (rPA), plasminogen activator inhibitor-1 (PAI-1) levels and the score of National Institutes of Health Stroke Scale (NIHSS) and Simple Mental State Scale (MMSE) in the occlusion group were observed.
Results There were statistically significant differences in type 2 diabetes mellitus, blood glucose, systolic blood pressure, NIHSS score and onset-thrombolysis time between the two groups (P < 0.05). Logistic regression analysis showed that type 2 diabetes mellitus, blood glucose, systolic blood pressure, NIHSS score, and onset- thrombolytic time were the influential factors of re-occlusion after intravenous thrombolytic alteplase in cerebral infarction patients (P < 0.05). The total effective rate was 88.10% (37/42) in 42 patients with re-occlusion after thrombolytic therapy. After 3 and 7 days of treatment, rPA was significantly higher than before treatment, PAI-1 was significantly lower than before treatment (P < 0.05); after 1 week, 2 and 4 weeks of treatment, MMSE score was significantly higher than before treatment, NIHSS score was significantly lower than before treatment (P < 0.05).
Conclusion Type 2 diabetes mellitus, blood glucose, systolic blood pressure, NIHSS score, and time of onset and thrombolytic therapy may affect the re-occlusion of patients with cerebral infarction after alteplase intravenous thrombolytic therapy. The effect of tirofiban after re-occlusion is better, which is beneficial to improve the neurological function, rPA and PAI-1 levels of patients.
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