Effects of Alteplase Combined with Tirofiban on Serum Cytokine Levels and Neurological Function in Patients with Acute Cerebral Infarction

Li Erhu; Guan Sheng; Jin Yazhou

doi:10.3969/j.issn.1004-5775.2025.01.017

Abstract：Objective:To investigate the effects of alteplase combined with tirofiban on serum cytokine levels and nerve function in patients with acute cerebral infarction.Methods:200 patients with acute non-cardiogenous ischemic stroke within 4.5 h of onset in the Department of Neurology of Luohe Sixth People's Hospital from January 2020 to February 2022 were selected,and divided into 4 groups according to different time periods after thrombolysis with tirofiban:＜2 h group,2～12 h group,12～24 h group and control group(without tirofiban),among which the three groups with tirofiban were the experimental group.NIHSS scores before,24 h,7 d and 14 d after thrombolysis and mRS scores 3 months after thrombolysis were recorded for all patients.The progression of clinical symptoms,bleeding,reinfarction and prognosis of all patients were observed.NIHSS scores were recorded before,24 h after thrombolytic,7 d after thrombolytic and 14 d after thrombolytic,and mRS scores were recorded 3 months after thrombolytic.The progress of clinical symptoms,bleeding,reinfarction and outcome of all patients were observed.Results:24 h after thrombolysis,the treatment effective rate of＜2 h group and 2～＜12 h group was better than the control group,the difference was statistically significant(χ2=5.84,3.35;P＜0.05).7 days after thrombolysis,the effective rate of＜2 h group and 2～<12 h group was better than that of control group,and the difference was statistically significant(χ2=5.19,3.40;P＜0.05).14 days after thrombolysis,the effective rate of＜2 h group and 2～＜12 h group was better than that of control group,and the difference was statistically significant(χ2=10.52,7.64;P＜0.05).Three months after thrombolysis,the good rate of＜2 h group,2～＜12 h group and 12～24 h group was better than that of control group,and the difference was statistically significant(χ2=7.48,6.13,1.65;P＜0.05).Symptom aggravation rate of experimental group was significantly lower than that of control group,the difference was statistically significant(χ2=3.34,P＜0.05).There was no significant difference in non-symptomatic cerebral hemorrhage,hemorrhage at other sites,symptomatic hemorrhage and brain death between the two groups(χ2=0.17,0.04,0;P＞0.05).Conclusion:Alteplase combined with tirofiban in the treatment of acute cerebral infarction patients can significantly reduce the level of serum cytokines,improve neurological function,and have good safety.