Thrombolysis with low-dose and standard-dose intravenous recombinant tissue plasminogen activator in elderly patients with acute ischemic stroke:a stratified analysis
10.3969/j.issn.1006-5725.2024.11.017
- VernacularTitle:小剂量和标准剂量rt-PA静脉溶栓治疗高龄急性缺血性脑卒中的分层研究
- Author:
Yawei GU
1
;
Xu CHU
;
Lujing ZHAO
;
Bo HONG
;
Zhikuan LUO
;
Zhanzeng LIN
;
Jingzhen GAO
;
Yinhua DONG
;
Lijun WANG
;
Nian CHEN
Author Information
1. 天津市中心医院神经内科(天津 300140)
- Keywords:
acute ischemic stroke;
advanced age;
tissue plasminogen activator;
thrombolysis
- From:
The Journal of Practical Medicine
2024;40(11):1568-1573
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of intravenous thrombolysis with low-dose and standard-dose recombinant tissue plasminogen activator(rt-PA)in the elderly patients(aged over 80 years)with acute ischemic stroke(AIS).Methods A total of 201 elderly patients with AIS treated at Tianjin Fourth Central Hospital from February 2019 to February 2023 were prospectively included and randomly assigned to the rt-PA low-dose group(n=93,0.6 mg/kg)and rt-PA standard-dose group(n=108,0.9 mg/kg).The incidence of intra-cranial hemorrhage,symptomatic intracranial hemorrhage,fatal intracranial hemorrhage,neurologic deterioration within 7 days and mortality within 90 days were observed to evaluate the safety.The neurologic improvement rate and good prognosis rate at 90 days were used to evaluate the effectiveness.A stratified analysis of 90-day outcomes was performed based on stroke severity and age.Results The incidence of intracranial hemorrhage,symptomatic intracranial hemorrhage and fatal intracranial hemorrhage within 7 days in rt-PA low-dose group was lower than that in rt-PA standard-dose group(P＜0.05).There were no statistically significant differences between the two groups concerning the residual safety index and the effectiveness index.The 90-day good prognosis rate of moderate stroke sub-group and of≥90 years of age sub-group in rt-PA low-dose group were both higher than that of rt-PA standard-dose group(P＜0.05).Conclusions For AIS patients with moderate stroke and aged over 90 years,intravenous thrombolytic therapy with rt-PA 0.6 mg/kg is recommended.
