Risk factors of progressive cerebral infarction in elderly patients with acute cerebral infarction and therapeutic efficacy of tirofiban
PENG Zongping
HU Wenxia
XU Chitian
YU Xiaoyan
LIANG Zhengling
HU Wei
Abstract：Objective To explore the risk factors for occurrence of progressive cerebral infarction (PCI) in elderly patients with acute cerebral infarction (ACI) and the clinical effectiveness of combination of intravenous thrombolysis and sequential tirofiban therapy. Methods A retrospective analysis was conducted on 480 elderly ACI patients undergoing thrombolysis in Department of Neurology of Lu'an People's Hospital from January 2020 to August 2024. According to the occurrence of PCI after thrombolysis,they were divided into a PCI group (87 cases) and a non-PCI group (393 cases). The patients in the PCI group were further assigned into a control group (43 cases,sequential alteplase intravenous thrombolysis)and a combined group (44 cases,sequential alteplase intravenous thrombolysis combined with tirofiban treatment) according to different treatment regimens. The neurological deficit[National Institutes of Health Stroke Scale (NIHSS)],platelet-related indicators[platelet hematocrit (PCT),platelet distribution width (PDW),platelet aggregation rate (PAgT)]and adverse reactions were compared between groups. Results The PCI group exhibited significantly advanced age,larger proportions of hyperlipidemia,diabetes mellitus and hypertension,higher NIHSS score at admission,increased platelet count at admission,and higher ratio of large artery atherosclerosis type than the non-PCI group (P<0.05,P<0.01). Hyperlipidemia (OR=2.776,95％CI:1.347-5.722,P=0.005),hypertension(OR=2.861,95％CI:1.258-6.503,P=0.012),and NIHSS score at admission(OR=1.141,95％CI:1.024-1.271,P=0.016)were independent risk factors for PCI occurrence in elderly ACI patients.For the PCI group,the combined subgroup exhibited notably lower NIHSS scores at 3,5 and 7 d after treatment than the control subgroup(P<0.05,P<0.01).After treatment,PCT was significantly higher while PDW and PAgT were notably lower in the combined subgroup than the control group(P<0.01).Conclusion The incidence of PCI is quite higher in elderly ACI patients.Intravenous thrombolysis sequential therapy combined with tirofiban treatment has significant efficacy and good safety in treating elderly ACI patients with PCI,and it also can improve platelet-related indicators.
Keywords：brain infarctiontirofibanrisk factorstissue plasminogen activatortreatment outcome
Publication Date：2026-02-15
Online Publishing Date：2026-03-11(First online date of this platform, not the publication date of the document)
Pages：4( 215-218 )