Study on the Efficacy and side effects of recombinant tissue plasminogen activator(rt-PA) intravenous thrombolysis on acute cerebral infarction within 4.5 h
CAO Zhaoyang1, LI Ming1, ZHU Xinjian1, ZHAO Lijun1, and LONG Yong2
1.Department of Neurology, Beijing Municipal Crops Hospital of Chinese People’s Armed Police Force, Beijing 100027, China; 2. Department of Epidemiology,the Fourth Military Medical University, Xi’an 710032, China
Abstract：Objective To explore the clinical efficiency and safety of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis for patients within 4.5 hous of acute cerebral infarction onset.Methods Eighty-one patients with acute cerebral infarction within four and a half hours of onset were chosen and divided into the thrombolysis group and control group. The thrombolysis group was given rt-PA 0.9 mg/kg intravenous thrombolysis while the control group received conventional treatments such as antiplatelet aggregation.The National Institutes of Health Stroke Scale (NIHSS) scores were compared before treatment and after treatment of 24 hours,7 days and 14 days,and adverse reactions were recorded.Results NIHSS scores were significantly reduced in the thrombolysis group after 24 h,7 d and 14 d of treatment, and there was significant difference between the thrombolysis group and the control group (P<0.05) .The total clinical effective rate was 86.21% in the thrombolysis group, but was 52.17% in the control group. The intracerebral hemorrhage rate in the thrombolysis group was 10.34% and symptomatic intracerebral hemorrhage rate was 3.45%, but they were 8.69% and 4.35% respectively in the control group. Thrombolysis fatality in the thrombolysis group was 5.17% compared with 8.69% in the control group(P=0.587).Conclusions Rt-PA intravenous thrombolysis within 4.5h of cerebral infarction is more effective than conventional treatments.
曹朝阳, 李明, 朱新建, 赵丽君, 龙泳. 重组组织型纤溶酶原激活药静脉溶栓治疗发病4.5 h内急性脑梗死的疗效和安全性[J]. 武警医学, 2017, 28(7): 653-655.
CAO Zhaoyang, LI Ming, ZHU Xinjian, ZHAO Lijun, and LONG Yong. Study on the Efficacy and side effects of recombinant tissue plasminogen activator(rt-PA) intravenous thrombolysis on acute cerebral infarction within 4.5 h. Med. J. Chin. Peop. Armed Poli. Forc., 2017, 28(7): 653-655.
Broderick J P, Palesch Y Y, Denmehuk A M, et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke [J]. N Engl J Med, 2013, 368(10): 893-903.
[2]
Ia Rose F R, Khoury J, Kissela B M, et al. Eligibility for intravenous recombinant tissue-type plasminogen activator with a population the effect of the European Cooperative Acute Stroke Study (ECASS) Ⅲ TRIAL [J]. Stroke, 2012, 43(6):1591-1595.
Wang Y, Liao X, Zhao X, et al. Using recombinant tissue plasminogen activator to treat acute ischemic stroke in China: analysis of the results from the Chinese Nation Stroke Registry (CNSR) [J]. Stroke, 2011, 42(7): 1658-1664
[6]
Kharitonova T, Mikulik R, Roine R O, et al. Association of early National Institutes of Health Stroke Scale improvement with vessel recanalization and functional outcome after intravenous thrombolysis in ischemic stroke[J]. Stroke, 2011, 42(6):1638-1643.
[7]
Wahlgren N,Ahmed N,Davalos A, et al. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study(SITS-MOST) : an observation study[J].Lancet,2007, 369(9558): 275-282.
[8]
Seet R C, Rabinstein A A. Symptomatic intracranial hemorrhage following intravenous thrombolysis for acute ischemic stroke: a critical review of case definitions [J]. Cerebrovasc Dis,2012,34(2):106-114.
2017, Vol. 28 
