Effects of Alteplase Combined with Tirofiban on the Risk Factors of Thrombosis in Rats with Acute Cerebral Infarction

Abstract

Background: Acute cerebral infarction (ACI) is an acute cerebrovascular disease with high mortality. Intravenous thrombolysis using alteplase is the primarily available treatment method for ACI, but it has limitations. Studies have shown that using tirofiban following alteplase can improve the stroke scale score in ACI patients. Therefore, we aimed to observe the effects of alteplase in combination with tirofiban on the risk factors of thrombosis in ACI. Methods: The disease model of ACI was established and divided into control, sham, model, alteplase, and combined (alteplase+tirofiban) groups. Bedersons method was applied to assess the neurobehavioral score of each group before and after treatment. The percentage of cerebral infarction was determined using the 2,3,5-triphenyltetrazolium chloride (TTC) staining method. Hematoxylin-Eosin (HE) staining approach was used to observe the pathological changes in the morphology of brain tissue. Furthermore, enzyme-linked immunosorbent assay (ELISA) was utilized to evaluate the levels of soluble P-selectin (sP-sel), von Willeophilic factor (vWF), endothelin-1 (ET-1), and interleukin-1β (IL-1β). A positive expression rate of intercellular adhesion molecule 1 (ICAM-1) was detected using immunohistochemistry methods. Results: There was no neurological impairment in the control and sham groups, and the model group showed no prominent change in neurobehavioral score before and after treatment (p > 0.05). However, in the alteplase and combined groups, the neurobehavioral scores were significantly reduced after treatment than before treatment (p < 0.05). When compared to the control group, the sham group did not exhibit any significant changes in cerebral infarction, while it was increased in the model group. However, compared with the model group, the area of cerebral infarction was found to be reduced in the alteplase and combined groups. Furthermore, normal brain cell morphology was observed in the control and sham groups, whereas it was disorderly arranged in the model group. Moreover, some brain cells in the alteplase group and a small number of brain cells in the combined group were also found to be disorganized. Compared to the control group, the levels of sP-sel and IL-1β were elevated in the sham and model groups. However, these levels were reduced in the alteplase and combined groups (p < 0.05). There was no significant difference in vWF and ET-1 levels, as well as the positive expression rate of ICAM-1, between the control and sham groups. However, they were significantly increased in the model group compared to the sham group. However, the contents of vWF and ET-1, as well as the expression of ICAM-1 in the alteplase and combined groups were decreased compared to the model group (p < 0.05). Conclusion: Alteplase in combination with tirofiban in ACI treatment reduced the area of cerebral infarction, down-regulated the expression of thrombosis risk factors, and alleviated arterial endothelial injury and inflammatory response, making it a method of choice rather than alteplase treatment alone.