Application of transcranial Doppler ultrasound in emergency thrombolytic therapy of ischemic stroke

Rena Abudusalamu; Xiaokelaiti Huojiahemaiti; Li Jiming; Peng Peng; Yusufujiang Yakufu

doi:10.3760/cma.j.issn.1673-4777.2018.01.017

Abstract：Objective To analyze the relation between changes of thrombolysis in brain ischemia(TIBI) classification and prognosis in thrombolytic therapy for patients with acute ischemic stroke.Methods Forty-one patients with acute ischemic stroke were enrolled from February 2013 to October 2015 in the First Affiliated Hospital of Xinjiang Medical University.All patients had thrombolytic therapy with recombinant tissue plasminogen activator;changes of TIBI were monitored by transcranial Doppler sonography.Relations among pre-thrombolysis TIBI,24 h and 7-10 d post-thrombolysis TIBI and score of the National Institutes of Health Stroke Scale(NIHSS) were analyzed;relation between 3-month post-thrombolysis TIBI and score of the modified-Rankin Scale (mRS) was analyzed.Results In 41 patients before thrombolysis,there were 29 cases(70.7％) of TIBI grade 0-1 [the NIHSS score =20(18,22)points] and 12 cases(29.3％) of TIBI grade 2-3[the NIHSS score =12(11,12)points].At 24 h after thrombolysis,there were 8 cases (19.5 ％) of TIBI grade 0-1 [the NIHSS score =18 (16,19) points],15 cases (36.6％) of TIBI grade 2-3 [the NIHSS score =13 (11,15) points] and 18 cases (43.9％) of TIBI grade 4-5[the NIHSS score =10(8,11)points].Pre-thrombolysis TIBI and 24 h post-thrombolysis TIBI were negatively related to the NIHSS score(r =-0.793,-0.639;P ＜ 0.001);7-10 d post-thrombolysis TIBI was negatively related to the NIHSS score(r =-0.745,P ＜0.001).Three-month post-thrombolysis TIBI was negatively related to the mRS score (r =-0.600,P =0.001).Conclusion TIBI classification is associated with neurologic impairment in patients with acute ischemic stroke;it is a good indicator of thrombolysis and prognosis.