{"title":"回顾性分析二级保健医院诊断为急性缺血性脑卒中并接受静脉溶栓治疗的患者资料。","authors":"Buse Cagla Ari","doi":"10.14744/nci.2021.33230","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Acute ischemic stroke is a cause of long-term disability in developing countries. Intravenous tissue plasminogen activator (iv-tPA) is the most effective medical treatment shown to provide clinical improvement. Our aim in this study is to investigate the relationship between the clinical data of our patients treated with iv-tPA and the changes in serum inflammatory parameters; and to help increase the prevalence of treatment in secondary hospitals.</p><p><strong>Methods: </strong>Forty-nine patients diagnosed as acute ischemic stroke and treated with iv-tPA at Siirt Research and Training Hospital between April 2019 and June 2020 were included in this study. Demographic and clinical findings, serum platelet/lymphocyte ratio (PLR), neutrophyle/ lymphocyte ratio (NLR) and CRP/albumin ratio (CAR), radiological data, symptom-door-needle times, trombectomy, complication and mortality rates, pre and post treatment 7<sup>th</sup> day of National Institutes of Health Stroke Scale Scores (NIHSS) and first and third-month of modified Rankin Scale (mRS) scores, and prognosis were evaluated.</p><p><strong>Results: </strong>The mean age was 71.2±13.7 years. Female-to-male ratio was almost 1. Decreases in the post-treatment NIHSS scores were statistically significant compared with the baseline (p<0.001). First month's mRS score was statistically decreased in the third month follow up significantly (p=0.002). There were significant differences between the baseline and post-treatment laboratory values. Significant increases in the values of NLR, and CAR were detected (p=0.012, p=0.009). Correlation analysis revealed significant positive correlations between post-treatment NIHSS and CAR, PLR, NLR. PLR and NLR were significantly correlated with the third month mRS score (p<0.001, p=0.011). Symptom-to-door time, door-to-needle time, and symptom-to-needle time were not correlated with the NIHSS and mRS scores.</p><p><strong>Conclusion: </strong>It would be beneficial to treat the patients with iv-tPA in secondary-staged hospitals and should be widespread. Rapid treatment is sufficient and can reduce complications and poor outcomes. Elevated levels of NLR, PLR, and CAR predict modest consequences.</p>","PeriodicalId":19164,"journal":{"name":"Northern Clinics of Istanbul","volume":"10 2","pages":"139-145"},"PeriodicalIF":0.9000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/74/NCI-10-139.PMC10170388.pdf","citationCount":"0","resultStr":"{\"title\":\"Retrospective analysis of the data of patients who were admitted to the secondary care hospital with the diagnosis of acute ischemic stroke and received intravenous thrombolytic therapy.\",\"authors\":\"Buse Cagla Ari\",\"doi\":\"10.14744/nci.2021.33230\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Acute ischemic stroke is a cause of long-term disability in developing countries. Intravenous tissue plasminogen activator (iv-tPA) is the most effective medical treatment shown to provide clinical improvement. Our aim in this study is to investigate the relationship between the clinical data of our patients treated with iv-tPA and the changes in serum inflammatory parameters; and to help increase the prevalence of treatment in secondary hospitals.</p><p><strong>Methods: </strong>Forty-nine patients diagnosed as acute ischemic stroke and treated with iv-tPA at Siirt Research and Training Hospital between April 2019 and June 2020 were included in this study. Demographic and clinical findings, serum platelet/lymphocyte ratio (PLR), neutrophyle/ lymphocyte ratio (NLR) and CRP/albumin ratio (CAR), radiological data, symptom-door-needle times, trombectomy, complication and mortality rates, pre and post treatment 7<sup>th</sup> day of National Institutes of Health Stroke Scale Scores (NIHSS) and first and third-month of modified Rankin Scale (mRS) scores, and prognosis were evaluated.</p><p><strong>Results: </strong>The mean age was 71.2±13.7 years. Female-to-male ratio was almost 1. Decreases in the post-treatment NIHSS scores were statistically significant compared with the baseline (p<0.001). First month's mRS score was statistically decreased in the third month follow up significantly (p=0.002). There were significant differences between the baseline and post-treatment laboratory values. Significant increases in the values of NLR, and CAR were detected (p=0.012, p=0.009). Correlation analysis revealed significant positive correlations between post-treatment NIHSS and CAR, PLR, NLR. PLR and NLR were significantly correlated with the third month mRS score (p<0.001, p=0.011). Symptom-to-door time, door-to-needle time, and symptom-to-needle time were not correlated with the NIHSS and mRS scores.</p><p><strong>Conclusion: </strong>It would be beneficial to treat the patients with iv-tPA in secondary-staged hospitals and should be widespread. Rapid treatment is sufficient and can reduce complications and poor outcomes. Elevated levels of NLR, PLR, and CAR predict modest consequences.</p>\",\"PeriodicalId\":19164,\"journal\":{\"name\":\"Northern Clinics of Istanbul\",\"volume\":\"10 2\",\"pages\":\"139-145\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/74/NCI-10-139.PMC10170388.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Northern Clinics of Istanbul\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14744/nci.2021.33230\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Northern Clinics of Istanbul","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14744/nci.2021.33230","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Retrospective analysis of the data of patients who were admitted to the secondary care hospital with the diagnosis of acute ischemic stroke and received intravenous thrombolytic therapy.
Objective: Acute ischemic stroke is a cause of long-term disability in developing countries. Intravenous tissue plasminogen activator (iv-tPA) is the most effective medical treatment shown to provide clinical improvement. Our aim in this study is to investigate the relationship between the clinical data of our patients treated with iv-tPA and the changes in serum inflammatory parameters; and to help increase the prevalence of treatment in secondary hospitals.
Methods: Forty-nine patients diagnosed as acute ischemic stroke and treated with iv-tPA at Siirt Research and Training Hospital between April 2019 and June 2020 were included in this study. Demographic and clinical findings, serum platelet/lymphocyte ratio (PLR), neutrophyle/ lymphocyte ratio (NLR) and CRP/albumin ratio (CAR), radiological data, symptom-door-needle times, trombectomy, complication and mortality rates, pre and post treatment 7th day of National Institutes of Health Stroke Scale Scores (NIHSS) and first and third-month of modified Rankin Scale (mRS) scores, and prognosis were evaluated.
Results: The mean age was 71.2±13.7 years. Female-to-male ratio was almost 1. Decreases in the post-treatment NIHSS scores were statistically significant compared with the baseline (p<0.001). First month's mRS score was statistically decreased in the third month follow up significantly (p=0.002). There were significant differences between the baseline and post-treatment laboratory values. Significant increases in the values of NLR, and CAR were detected (p=0.012, p=0.009). Correlation analysis revealed significant positive correlations between post-treatment NIHSS and CAR, PLR, NLR. PLR and NLR were significantly correlated with the third month mRS score (p<0.001, p=0.011). Symptom-to-door time, door-to-needle time, and symptom-to-needle time were not correlated with the NIHSS and mRS scores.
Conclusion: It would be beneficial to treat the patients with iv-tPA in secondary-staged hospitals and should be widespread. Rapid treatment is sufficient and can reduce complications and poor outcomes. Elevated levels of NLR, PLR, and CAR predict modest consequences.