Effects of Ultra-early Alteplase Intravenous Thrombolysis in Patients with Acute Cerebral Infarction and the Influencing Factors of Deterioration After Improvement

International journal of cerebrovascular disease and stroke Pub Date : 2019-01-01 DOI:10.29011/2688-8734.100012

Hong Zhang, J. Leng, Yan-ping Wang, Xiao Chen, Liu Shi

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Abstract

Objective: To analyze the effects of ultra-early alteplase (rt-PA) intravenous thrombolysis in patients with Acute Cerebral Infarction (ACI) and the influencing factors of deterioration after improvement. Methods: A total of 70 patients with ACI treated by rt-PA intravenous thrombolysis in our hospital from January 2014 to December 2016 were selected as the observation group, and another 90 patients with ACI who only received conventional treatment were selected as the control group. The status of neurological impairment was evaluated with the National Institutes of Health Stroke Scale (NIHSS) and the prognosis was evaluated with the Barthel Index (BI) and modified Rankin Scale (mRS). The incidence of complications was statistically analyzed. Patients in the observation group were divided into the deterioration group (n=9) and the non-deterioration group (n=61). the clinical data were collected for univariate analysis and factors with significant differences were analyzed by Logistic regression analysis. Results: Before treatment, there were no significant differences between the two groups in NIHSS score, BI and mRS score, while after treatment, the above-mentioned indexes were significantly improved, and the improvement was more obvious in the observation group than the control group. Multivariable Logistic regression analysis showed that age, previous history of atrial fibrillation, late thrombolysis, high NIHSS score before thrombolysis, low white blood cell count and total anterior circulation infarction were independent risk factors for deterioration after improvement. Conclusion: Ultra-early rt-PA intravenous thrombolysis can quickly correct the status of cerebral ischemia and hypoxia and save the damaged neurological function in patients with ACI, and attention should be paid to the independent risk factors for deterioration after improvement.

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超早期阿替普酶静脉溶栓治疗急性脑梗死的疗效及改善后病情恶化的影响因素

目的:分析超早期阿替普酶(rt-PA)静脉溶栓治疗急性脑梗死(ACI)的疗效及改善后病情恶化的影响因素。方法:选取2014年1月至2016年12月在我院接受rt-PA静脉溶栓治疗的ACI患者70例作为观察组，选取仅接受常规治疗的ACI患者90例作为对照组。采用美国国立卫生研究院卒中量表(NIHSS)评估神经功能损害状况，采用Barthel指数(BI)和改良Rankin量表(mRS)评估预后。统计分析并发症的发生情况。观察组患者分为恶化组(n=9)和非恶化组(n=61)。收集临床资料进行单因素分析，对差异显著的因素进行Logistic回归分析。结果:治疗前两组患者NIHSS评分、BI评分、mRS评分差异无统计学意义，治疗后上述指标均有显著改善，且观察组改善较对照组更明显。多变量Logistic回归分析显示，年龄、既往房颤病史、溶栓晚、溶栓前NIHSS评分高、白细胞计数低、前循环总梗死是改善后病情恶化的独立危险因素。结论:超早期rt-PA静脉溶栓可快速纠正ACI患者脑缺血缺氧状态，挽救受损神经功能，改善后应注意病情恶化的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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International journal of cerebrovascular disease and stroke

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