Efficacy and safety of tenecteplase combined with nicergoline in treatment of ischemic stroke

Zhao Wei-li; Liu Ya-lin; Zhang Qian; Zhao Yang; Li Xi-peng; Zhao Rui-jie

doi:10.3969/j.issn.1672-8157.2025.02.028

Abstract：Objective To investigate the clinical efficacy and safety of tenecteplase combined with nicergoline in the treatment of ischemic stroke.Methods Ninety-eight patients with ischemic stroke admitted to Xingtai People's Hospital from August 2022 to July 2024 were selected and divided into the combined group and the pair of single-drug group by using the randomized numerical table method,with 49 in each group.The patients in the combination group were treated with tenecteplase combined with nicergoline,and those in the single-drug group were treated with tenecteplase only.All the patients in both groups were treated for 14 d.The neurological function,ability to live,ca-rotid intima-media thickness,carotid plaque area,and levels of brain-derived neurotrophic factor,nerve growth factor,angiopoietin-1,and D-dimer before and after the treatment were compared between the two groups.Meanwhile,the safety of their medication was determined.Results The National Institute of health stroke scale score and modified Rankin scale score((3.65±1.28)points and(1.12±0.86)points)in the combination group were lower than those in the single-drug group((4.82±1.54)points and(1.78±0.96)points)after treatment(t=4.090,3.584,both P<0.05).The carotid intima-media thickness and carotid plaque area in the combination group((0.83±0.15)mm,(0.50±0.06)mm2)were lower than those in the single-agent group((0.95±0.17)mm,(0.61±0.09)mm2)(t=3.705,7.119,both P<0.05).The lev-els of brain-derived neurotrophic factor,nerve growth factor and angiopoietin-1 in the combination group((20.56±3.34)ng·mL-1,(15.46±3.27)ng·mL-1,(319.45±51.26)pg·mL-1)were higher than those in the single-drug group((16.01±3.18)ng·mL-1,(10.63±3.39)ng·mL-1,(280.11±57.82)pg·mL-1),and the D-dimer level((779.45±148.16)pg·mL-1)was lower than that in the single-drug group((934.11±150.82)pg·mL-1)(t=6.906,7.178,3.564,5.121,all P<0.05).During the treatment period and 3 months after treatment,there was no apparent-ly significant difference in the complication rates of cerebral hemorrhage,gastrointestinal hemorrhage,skin and mucous membrane bleeding,atrial fibrillation,and hypotension between the two groups(P>0.05).Conclusion Teneplase combined with nicergoline can significantly improve the neurological function,life ability,neurotrophic factor and coagulation index level of ischemic stroke patients.Meanwhile,it can delay the occurrence and development of carotid artery atherosclerosis,with good safety.