Efficacy of CTP-based thrombolytic therapy in acute ischemic stroke patients with unclear onset time
LI Qiang
WANG Hong-xin
Abstract：Objective To evaluate the efficacy and safety of CT perfusion ( CTP)-based thrombolytic therapy in acute ischemic stroke patients with unclear onset time.Methods The acute ischemic stroke patients with unclear onset time were selected.After patients or relatives signed the informed consent, they were scanned by CTP.Seventy-two patients with ischemic penumbra received intravenous thrombolysis of recombinant tissue plasminogen activator ( rt-PA) ( CTP group) , and at the same time, the cerebral infarction patients whose onset time was within 4.5 h were enrolled as thrombolysis-con-trol group (control group, 80 cases).The NIHSS was recorded before,and 2 hours, 24 hours, 14 days and 30 days after thrombolytic therapy.The Barthel index ( BI) and modified Rankin scale( mRs) score were recorded before thrombolysis and 30 days after thrombolysis.CT was also re-examined 24 h after thrombolysis, and the adverse reactions were moni-tored.The level of matrix metalloproteinase 9 (MMP-9) was detected in the two groups before, 24 hours and 14 days after thrombolytic therapy.Results NIHSS scores were improved at different time points in the CTP group after the rt-PA intra-venous thrombolysis as compared with those before treatment, and significant difference was observed (all P<0.05).In contrast, no significant change of the NIHSS score was observed in the control group at 24 hours, and it significantly im-proved until 14 days and 30 days after treatment (P<0.05).No significant difference was found in the NIHSS score be-tween the CTP group and the control group 24 h after treatment (P﹥0.05).The mRs score was significantly improved in the two groups as compared with before treatment (P<0.05), but there was no significant difference in the mRs score be-tween the two groups (P>0.05).The Barthel index was significantly improved in the two groups (all P<0.05), but there was no significant difference in the Barthel index between the two groups (P>0.05).There was no significant differ-ence in the MMP-9 level before treatment and 24 hours after treatment between the two groups (P﹥0.05).At day 14, the MMP-9 level in the CPT group was significantly lower than that of the control group (P<0.05).The examinations of blood routine, urine routine and stool routine were normal, and the intracranial hemorrhage and blocking were not seen. Conclusions For unclear-onset acute ischemic stroke patients with ischemic penumbra after CTP examination, the rt-PA intravenous thrombolysis is safe and effective.
Keywords：strokerecombinant tissue plasminogen activatorintravenous thrombolysismatrix metalloproteinase 9
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 5-7 )