Curative effect of butylphthalide combined with low-dose recombinant tissue-type plasminogen activator for intravenous thrombolytic therapy in elderly patients with ultra-early cerebral infarction

doi:10.11958/20230414

Abstract

Abstract:

Objective To explore the curative effect of butylphthalide (D) combined with low-dose recombinant tissue-type plasminogen activator (rt-PA) for intravenous thrombolysis on elderly patients with ultra-early cerebral infarction. Methods A total of 156 elderly patients with ultra-early cerebral infarction were retrospectively enrolled as the research objects. According to different treatment methods, patients were divided into the D+low rtPA group [30 cases, butylphthalide combined with low-dose (0.6 mg/kg) rt-PA], the D+standard rtPA group [62 cases, butylphthalide combined with standard-dose (0.9 mg/kg) rt-PA], the low rtPA group [30 cases, low-dose (0.6 mg/kg) rt-PA] and the standard rtPA group [34 cases, standard-dose (0.9 mg/kg) rt-PA]. After thrombolysis, scores of National Institutes of Health Stroke Scale (NHISS), Modified Rankin Scale (mRS) and activity of daily living (ADL), and inflammation indexes were compared between the four groups. The poor prognosis was statistically analyzed. Results After 7 days of thrombolysis, the addition of butylphthalide reduced NHISS and mRS scores, as well as neutrophil count (NET), platelet count (PLT) and neutrophil absolute value/lymphocyte absolute value (NLR) levels (P<0.05), while increased ADL scores and lymphocyte count (LYT, P<0.05). The levels of NHISS score, mRS score, ADL score, NET, LYT, PLT, NLR and platelet absolute value/neutrophil absolute value (PNR) were not affected by different doses of rt-PA (P>0.05). There was no significant difference in the overall adverse prognosis rate between the four groups (P>0.05). Conclusion Butylphthalide combined with low-dose and standard-dose rt-PA is safe and effective in the treatment of elderly patients with ultra-early cerebral infarction.

Key words: brain infarction, recombinant tissue plasminogen activator, aged, super early stage, butylphthalide, curative effect

CLC Number:

R743.33

Figures/Tables 6

References 24

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组别	n	年龄/岁	性别（男/女）	发病时间/h	合并症
组别	n	年龄/岁	性别（男/女）	发病时间/h	高血压	糖尿病	房颤
低rt-PA组	30	84.17±4.24	9/21	2.92±0.92	15	9	5
标rt-PA组	34	76.12±4.24^a	16/18	2.87±1.04	23	8	9
丁+低rt-PA组	30	82.47±5.20	15/15	2.90±0.99	24	9	4
丁+标rt-PA组	62	75.53±4.29^ac	33/29	2.86±0.85	40	17	9
F或χ²		36.387^＊＊	4.553	0.029	6.066	0.456	2.672

组别	n	年龄/岁	性别（男/女）	发病时间/h	合并症
组别	n	年龄/岁	性别（男/女）	发病时间/h	高血压	糖尿病	房颤
低rt-PA组	30	84.17±4.24	9/21	2.92±0.92	15	9	5
标rt-PA组	34	76.12±4.24^a	16/18	2.87±1.04	23	8	9
丁+低rt-PA组	30	82.47±5.20	15/15	2.90±0.99	24	9	4
丁+标rt-PA组	62	75.53±4.29^ac	33/29	2.86±0.85	40	17	9
F或χ²		36.387^＊＊	4.553	0.029	6.066	0.456	2.672

组别	n	溶栓前	溶栓后1 h	溶栓后1 d	溶栓后7 d
低rt-PA组	30	11.50（5.75，15.00）	10.50（4.75，15.00）	10.00（5.00，14.25）	8.50（2.75，13.25）
标rt-PA组	34	9.50（5.75，16.00）	9.50（3.00，16.25）	9.00（3.00，16.25）	7.00（2.00，13.25）
丁+低rt-PA组	30	12.50（6.00，19.25）	7.00（3.00，11.00）	7.00（2.00，10.00）	5.00（2.00，8.00）
丁+标rt-PA组	62	11.00（7.00，16.00）	8.00（4.00，12.25）	8.00（4.00，11.25）	5.00（3.00，7.25）
H_A		0.504	1.522	2.193	5.112^＊
H_B		0.376	0.026	0.236	0.175
H_A×B		0.030	0.187	1.081	0.492

组别	n	溶栓前	溶栓后1 h	溶栓后1 d	溶栓后7 d
低rt-PA组	30	11.50（5.75，15.00）	10.50（4.75，15.00）	10.00（5.00，14.25）	8.50（2.75，13.25）
标rt-PA组	34	9.50（5.75，16.00）	9.50（3.00，16.25）	9.00（3.00，16.25）	7.00（2.00，13.25）
丁+低rt-PA组	30	12.50（6.00，19.25）	7.00（3.00，11.00）	7.00（2.00，10.00）	5.00（2.00，8.00）
丁+标rt-PA组	62	11.00（7.00，16.00）	8.00（4.00，12.25）	8.00（4.00，11.25）	5.00（3.00，7.25）
H_A		0.504	1.522	2.193	5.112^＊
H_B		0.376	0.026	0.236	0.175
H_A×B		0.030	0.187	1.081	0.492

组别	n	溶栓前	溶栓后1 d	溶栓后7 d
低rt-PA组	30	20.00（10.00，40.00）	30.00（15.00，45.00）	40.00（20.00，51.25）
标rt-PA组	34	20.00（10.00，36.25）	30.00（10.00，47.50）	47.50（10.00，65.00）
丁+低rt-PA组	30	25.00（10.00，37.50）	42.50（20.00，55.00）	50.00（33.75，70.00）
丁+标rt-PA组	62	25.00（20.00，35.00）	40.00（25.00，60.00）	50.00（35.00，76.25）
H_A		1.390	8.598^＊＊	4.889^＊
H_B		0.358	0.017	0.644
H_A×B		0.290	0.017	0.035