Clinical study of troxerutin combined with r-tPA for acute ischemic stroke beyond the time window
Wu Yue
Dong Fenfen
Tang Lingzhi
Qin Min
Liu Ting
Qu Fei
Huang Yunfang
Abstract：Objective To investigate the clinical efficacy of troxerutin combined with recombinant tissue plasminogen activator(r-tPA)for acute ischemic stroke(AIS)beyond the time window(4.5-8 hours post-onset),providing references for treating such patients.Methods A total of 236 AIS patients beyond the time window treated at Shangluo Central Hospital from Janu-ary 2022 to May 2024 were randomized into control group(n=118)and study group(n=118).Both groups received conven-tional therapy;the control group received r-tPA alone,while the study group received troxerutin plus r-tPA for 2 weeks.Cere-bral hemodynamics,cerebral perfusion parameters,serum factor levels,neurological recovery,90-day prognosis,and adverse drug reactions were compared before and after treatment.Results Before treatment,no significant differences was observed in mean flow velocity(Vm),end-diastolic velocity(Vd),or peak systolic velocity(Vp)between groups(P＞0.05);post-treat-ment,all velocities increased significantly in both groups versus pre-treatment,with significantly higher values in the study group versus control(P＜0.05).No pre-treatment differences were found in mean transit time(MTT),cerebral blood volume(CBV),or cerebral blood flow(CBF)(P＞0.05);post-treatment,CBV and CBF increased in both groups versus pre-treat-ment,with higher values in the study group,while MTT shortened in both groups versus pre-treatment,with shorter MTT in the study group,all with statistical significance(P＜0.05).No pre-treatment differences were noted in serum soluble Fas(sFas)or soluble Fas ligand(sFasL)levels(P＞0.05);post-treatment,both markers decreased significantly in both groups versus pre-treatment,with significantly lower levels in the study group(P＜0.05).Pre-treatment National Institutes of Health Stroke Scale(NIHSS)and modified Rankin Scale(mRS)scores showed no significant differences(P＞0.05);post-treatment scores of NIHSS and mRS scores decreased significantly in both groups versus pre-treatment,with significantly low-er scores in the study group(P＜0.05).Adverse reaction rates were 13.56％(16/118)in the study group and 9.32％(11/118)in the control group,without statistical significance(x2=1.046,P=0.307).Ninety-day mortality was 1.69％(2/118)in the study group versus 2.54％(3/118)in the control group,showing no significant differences(x2=0.000,P=1.000).Conclusion Troxerutin combined with r-tPA improves cerebral hemodynamics,cerebral perfusion,and neurological function in AIS patients beyond the time window without increasing adverse reaction risks.
Keywords：Troxerutinr-tPA therapyThrombolysis time windowAcute ischemic strokeNeurological function
Publication Date：2025-05-20
Online Publishing Date：2025-09-04(First online date of this platform, not the publication date of the document)
Pages：6( 121-126 )