Analysis of the efficacy of combining tirofiban with Shuxuetong in the treatment of acute cerebral infarction

Shi Di; Wang Nuan; Zhou Hao; Zhao Chao; Yan Yuqing; Geng Ziyang; Zhang Jin

doi:10.3969/j.issn.1671-6450.2024.03.008

Abstract：Objective To observe the effect of Shuxuetong combined with tirofiban in the treatment of acute cere-bral infarction.Methods Eighty-six patients with acute cerebral infarction treated in the Department of Neurology of Xuzhou Municipal Hospital affiliated to Xuzhou Medical University from March 2021 to April 2023 were included in the study,and they were divided into single-medicine group(43 cases,tirofiban)and combined-medicine group(43 cases,Shux-uetong +tirofiban)by randomized numerical table,and the patients of the two groups underwent conventional basic treat-ment,and the cerebral hemodynamics was measured and compared before and after the treatment.Cerebral hemodynamic in-dexes(mean blood flow velocity of common carotid artery,cerebrovascular peripheral resistance),oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH-Px)],inflammatory factors[interleukin(IL)-4,IL-6,tumor necrosis factor-alpha(TNF-alpha)],and vascular endothelial function indexes[vascular pseudohaemo-philic factor(VPF)]were measured before and after treatment[vascular pseudohemophilic factor(vWF),endothelin-1(ET-1),intercellular adhesion molecule-1(ICAM-1)],to assess the patients'self-care ability,neurological impairment improvement,and to count the adverse reactions such as nausea,gingival bleeding,rash during the drug administration.Results After treatment,the mean blood flow velocity of the common carotid artery in the combination group was higher than that in the single-drug group,and the peripheral vascular resistance was lower than that in the single-drug group(t/P=4.991/<0.001,2.898/0.005);the levels of serum SOD and GSH-Px were higher than that in the single-drug group,and the level of MDA was lower than that in the single-drug group(t/P=4.991/<0.001,2.898/0.005).were lower than those in the single-drug group(t/P=5.711/<0.001,4.305/<0.001,7.927/<0.001);serum IL-4,IL-6,and TNF-αlevels were significantly lower than those in the single-drug group(t/P=8.886/<0.001,9.312/<0.001,6.984/<0.001);serum vWF,ET-1,and ICAM-1 levels were significantly lower than those in the single-drug group(t/P=8.314/<0.001,9.824/<0.001,11.054/<0.001);scores of self-care ability in daily life were higher than those of the single-drug group,and scores of neurological deficits were significant-ly lower than those of the single-drug group(t/P=9.188/<0.001,10.946/<0.001);there was no statistically significant difference in the comparison of the total incidence of adverse reactions,such as gingival bleeding and rash,between the 2 groups(P>0.05).Conclusion The application of Shuxuetong combined with tirofiban in the treatment of acute cerebralin-farction can restore cerebral hemodynamics,reduce oxidative stress injury and improve inflammation,improve the endothelial function of the patients,and restore their ability of self-care,and the combination of treatments did not significantly increase the adverse reactions.