Efficacy of intravenous thrombolysis with alteplase in the treatment of acute ischemic stroke
10.3760/cma.j.cn341190-20241119-01532
- VernacularTitle:阿替普酶静脉溶栓治疗急性缺血性脑卒中效果观察
- Author:
Xianyong DAI
1
Author Information
1. 临海市第二人民医院神经内科，临海 317016
- Publication Type:Journal Article
- Keywords:
Brain ischemia;
Stroke;
Tissue plasminogen activator;
Fibrinogen;
Prothrombin time;
C-reactive protein;
Cysteine
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(8):1147-1151
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of intravenous thrombolysis with alteplase in the treatment of acute ischemic stroke in patients.Methods:This study used a retrospective study design. A total of 86 patients with acute ischemic stroke who received treatment at Linhai Second People's Hospital from January 2022 to August 2024 were included in this study. Based on whether they received thrombolysis within the treatment window, the patients were divided into a control group and an observation group, with 43 patients in each group. The control group received conventional medication treatment, while the observation group received intravenous thrombolysis with alteplase in addition to the conventional medication. The efficacy of both groups was compared by assessing the National Institutes of Health Stroke Scale scores before thrombolysis, as well as 24 hours and 7 days after thrombolysis. Changes in coagulation indicators, C-reactive protein, and homocysteine levels were also measured before and 7 days after thrombolysis.Results:The total response rate in the observation group [72.09% (31/43)] was significantly higher than that in the control group [41.86% (18/43), χ2 = 8.02, P < 0.05]. The National Institutes of Health Stroke Scale scores in the observation group were (11.41 ± 2.65) and (7.63 ± 2.18) at 24 hours and 7 days after thrombolysis, respectively. These scores were significantly lower than those corresponding scores in the control group [(13.76 ± 2.31), (10.23 ± 2.45), t = 4.38, 5.20, both P < 0.05]. At 7 days after thrombolysis, the observation group had lower levels of D-dimer [(0.17 ± 0.05) mg/L] and fibrinogen [(2.42 ± 0.49) g/L] compared with the control group [(0.36 ± 0.10) mg/L, (3.41 ± 0.57) g/L, t = 11.14, 8.64, both P < 0.05], while the prothrombin time in the observation group [(18.82 ± 1.71) seconds] was significantly longer than that in the control group [(16.47 ± 1.56) seconds, t = 6.66, P < 0.05]. Additionally, serum levels of C-reactive protein [(3.26 ± 1.04) mg/L] and homocysteine [(8.74 ± 1.65) μmol/L] in the observation group were significantly lower than those in the control group [(4.37 ± 0.98) mg/L, (10.87 ± 1.08) μmol/L, t = 5.09, 7.08, both P < 0.05]. Conclusions:Intravenous thrombolysis with ateplase for acute ischemic stroke is effective in improving patients' neurological function and coagulation function and reducing serum levels of C-reactive protein and homocysteine.
