Effectiveness of Urokinase and Alteplase in the treatment of super-aged patients with acute ischemic stroke#br#
ZHOU Ting1,2 LIAO Juan2,3 LIU Li4 ZHAO Libo1,2,3 YANG Yonghong1,2 LIU Qingjun1,2 LIU Shudong1,2 YANG Deyu1,2,3,5
1.Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China;
2.Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing 402160, China;
3.Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China;
4.Department of Health Management, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China;
5.Department of Internal Medicine, Changdu People’s Hospital, Tibet Region, Changdu 854000, China
Objective To explore the effectiveness of Urokinase and Alteplase in the treatment of super-aged patients with acute ischemic stroke (AIS). Methods The clinical data of 106 super-aged patients with AIS treated in Yongchuan Hospital of Chongqing Medical University from June 2017 to October 2020 was analyzed retrospectively. According to different thrombolytic drugs, they were divided into Urokinase group (44 cases) and Alteplase group (62 cases). Twenty-nine pairs of patients in two groups were screened by propensity score matching, including 17 patients with large vessel occlusion (LVO) and 12 patients with non-LVO in the Urokinase group, Alteplase group included 20 LVO patients and 9 non-LVO patients. The baseline characteristics and observation indexes (rate of favorable outcome, modified Rankin scale[mRS] score at 90 days, changes of the National Institutes of Health stroke scale score, death rate, rate of intracranial hemorrhage, rate of symptomatic intracranial hemorrhage, and rate of extracranial hemorrhage) were compared between the two groups. Results Before matching, the time from onset to thrombolysis in urokinase group was longer than that in Alteplase group, the difference was statistically significant (P ＜ 0.05), while there was no significant difference in other baseline data and observation indicators (P ＞ 0.05). After matching, there were no significant differences in baseline data and observation indicators between the two groups (P ＞ 0.05). In LVO patients, the rate of favorable outcome of Urokinase group was lower than that of alteplase group, and the mRS score at 90 days was higher than that of Alteplase group, with statistical significance (P ＜ 0.05). In non-LVO patients, there was no statistical significance between the two groups (P ＞ 0.05). Conclusion Intravenous Urokinase thrombolytic therapy for AIS in super-aged patients is relatively safe and effective. In super-aged patients with non-LVO stroke, the efficacy of Urokinase is comparable to that of Alteplase intravenous thrombolytic therapy, and it can be used as a substitute for Alteplase.
周婷1,2 廖娟2,3 刘莉4 赵立波1,2,3 杨永红1,2 刘庆军1,2 刘曙东1,2 杨德雨1,2,3,5. 尿激酶和阿替普酶治疗超高龄急性缺血性脑卒中患者的效果[J]. 中国医药导报, 2021, 18(32): 87-91.
ZHOU Ting1,2 LIAO Juan2,3 LIU Li4 ZHAO Libo1,2,3 YANG Yonghong1,2 LIU Qingjun1,2 LIU Shudong1,2 YANG Deyu1,2,3,5. Effectiveness of Urokinase and Alteplase in the treatment of super-aged patients with acute ischemic stroke#br#. 中国医药导报, 2021, 18(32): 87-91.
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