Abstract: Objective  To investigate the safety and efficacy of  urokinase  plus  tirofiban in the treatment of acute ischemic stroke patients. Methods  Fifty patients with acute ischemic stroke were infused intravenously urokinase  1 500 000   U and then were randomized into two groups.  25 patients in tirofiban group were infused tirofiban （0.4  μg/［kg·min］   for  30 min， and then 0.1 μg/［kg·min］  for  72 h）     immediately  after urokinase,while  25 patients in the control  group received no tirofiban. The incidences of intracranial hemorrhage, systematic bleedings and death during the first 14 days were recorded. The National Institutes of Health Stroke  Score at day 14 and modified Rankin scale at 3 months were assessed.Results  There were no statistical differences in the incidences of symptomatic intracranial hemorrhage， intracranial hemorrhage, systematic bleedings and death during the first 14 days (P>0.05)  between the two groups. At day 14 the average National Institutes of Health Stroke Score in tirofiban group was significantly lower than that of  control group(7.46 versus 9.48，P=0.032)，and at 3 months more patients had favorable outcomes of modified Rankin scale 0 to 2 (2.6 versus 1， P=0.038).Conclusion  Intravenous tirofiban immediately after urokinase can improve outcomes of acute ischemic stroke patients without increasing the events of bleedings. It is safe and potentially more effective when compared with urokinase alone for acute stroke patients.

Key words: brain infarction, tirofiban, urokinase, safety, efficacy