Observation of intravenous recombinant tissue-type plasminogen activator thrombolytic therapy in acute cerebral infarction (6 hours) of carotid artery

WANG Hui

doi:10.3760/cma.j.issn.1673-4777.2011.10.018

Abstract：Objective To evaluate the efficacy and safety of intravenous recombinant tissue-type plasminogen activator(rtPA) for the therapy of acute cerebral infarctions within 6 hours from symptom onset. Methods A randomized and controlled clinical study was performed. Forty patients consistent with the thrombolysis group criteria received rtPA 50 mg intravenously in one minute. 24 hours after thrombolysis, 100 mg aspirin was administered perday. Meliorate scandinavian stroke scale (MESSS) was used to evaluate the neurological deficits and the MESSS scores were recorded on the following time points: pretherapy, 2 hours, 24 hours, 3 days, 7 days, 14 days, 30 days, and 90 days after thrombolysis. Forty patients consistent with the controlled group criteria received routine treatment. 24 hours after entering wards, 100 mg aspirin was administered per day. MESSS was used to evaluate the neurological deficits and the MESSS scores were recorded on the following time points: pretherapy, 24 hours, 3 days, 7 days, 14 days, 30 days, and 90 days after therapy. All patients received head CT scan or MRI, complete blood count, coagulative time, electrocardiogram before therapy. Results Compared with control group[(24.23 ±6.23) ,(21.37 ±4.12),(21.17 ±3.68), (18.53 ±3.55), (15.87 ±3.49), (9.98 ± 1.95) scores], MESSS scores of thrombolysis group 24 hours, 3 days, 7 days, 14 days, 30 days, and 90 days after therapy[( 14.43 ±11.61) ,(9.88 ± 10.44),(9.27 ±9.66),(8.27 ±9.54),(7.79 ±9.13),(5.13 ±6.75) scores]decreased rapidly after thrombolysis. There was significant difference between 2 groups( P ＜0.05 ). One non-symptomatic hemorrhage onset was found. There was not dead case. Conclusion rtPA is effective and relatively safe in treatment of acute cerebral infarctions within 6 hours after symptom onset.