Volume 22 Issue 1
Jan.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(1): 70-73
KOU Qixing, QU Xueping, LIU Songcan, SUN Gen, JI Peng. Analysis of the effect of reperfusion after intravenous thrombolysis in different time windows of acute ischemic stroke on clinical outcome and 90-day prognosis[J]. Chinese Journal of General Practice, 2024, 22(1): 70-73. doi: 10.16766/j.cnki.issn.1674-4152.003333
Citation: KOU Qixing, QU Xueping, LIU Songcan, SUN Gen, JI Peng. Analysis of the effect of reperfusion after intravenous thrombolysis in different time windows of acute ischemic stroke on clinical outcome and 90-day prognosis[J]. Chinese Journal of General Practice, 2024, 22(1): 70-73. doi: 10.16766/j.cnki.issn.1674-4152.003333
shu

Analysis of the effect of reperfusion after intravenous thrombolysis in different time windows of acute ischemic stroke on clinical outcome and 90-day prognosis

doi: 10.16766/j.cnki.issn.1674-4152.003333

  • Department of Neurology, North District, the Third People's Hospital of Zhengzhou city (Cancer Hospital of Henan University), Zhengzhou, Henan 450049, China

Funds:

 222102310473

  • Received Date: 2023-04-09
    Available Online: 2024-03-09
    Abstract
  •   Objective  To analyze the effect of reperfusion after thrombolysis in different time windows on clinical outcome and 90-day prognosis of acute ischemic stroke (AIS).  Methods  A total of 158 AIS patients who received intravenous thrombolytic therapy in the Department of Neurology of the Northern Ward of the Third People's Hospital of Zhengzhou from October 2020 to October 2022 were selected. The patients were divided into three groups according to the thrombolytic time window: A(42 cases), B (53 cases) and C (63 cases). The thrombolytic time windows were < 3.0 h, 3.0-4.5 h, and >4.5- < 6.0 h, respectively. The clinical results of the three groups were compared. After 90 days of follow-up, the patients were divided into a good prognosis group (89 cases) and a poor prognosis group (69 cases) according to the modified Rankin scale (mRS), and the factors influencing the prognosis of the patients at 90 days were analyzed.  Results  The National Institutes of health stroke scale (NIHSS) score after thrombolysis in group A and group B was lower than that in group C, and the rate of short-term good prognosis was higher than that in group C (P < 0.05). There was no statistical significance in NIHSS score and short-term good prognosis between group A and group B (P>0.05). The incidence of bleeding events in the three groups was 4 (9.52%), 7 (13.21%), and 10 (15.87%), respectively, with no significant difference (χ2=0.882, P>0.05). In the poor prognosis group, age [(67.20±10.33) vs. (60.69±10.41) years], NIHSS score at admission [(12.35±3.50) points vs. (7.91±2.12) points], proportion of atrial fibrillation (17.39% vs. 3.37%) and proportion of thrombolysis >4.5- < 6.0 h after onset (53.62% vs. 29.21%) were higher than in the good prognosis group (P < 0.05). Logistic regression showed that older age, high admission NIHSS score, atrial fibrillation, and thrombolysis time window >4.5- < 6.0 h were independent risk factors for poor prognosis in AIS patients (P < 0.05).  Conclusion  Thrombolysis is beneficial within 4.5 hours of AIS onset. Age, NIHSS score on admission, atrial fibrillation, and time window of thrombolysis may influence the 90-day prognosis of AIS patients.

     

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    • References(20)
  • [1]
    RABINSTEIN A A. Update on treatment of acute ischemic stroke[J]. Continuum (Minneap Minn), 2020, 26(2): 268-286.
    [2]
    OHTA T, OKADA K, FUKUDA M, et al. Safety and efficacy of intravenous low-dose alteplase in relative contraindication patients with acute ischemic stroke[J]. J Stroke Cerebrovasc Dis, 2018, 27(7): 1844-1851. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.026
    [3]
    RØNNING O M, LOGALLO N, THOMMESSEN B, et al. Tenecteplase versus alteplase between 3 and 4.5 hours in low national institutes of health stroke scale[J]. Stroke, 2019, 50(2): 498-500. doi: 10.1161/STROKEAHA.118.024223
    [4]
    中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682. doi: 10.3760/cma.j.issn.1006-7876.2018.09.004

    Chinese Society of Neurology, Chinese Society of Neurology, Chinese Society of Cerebrovascular Disease. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018[J]. Chinese Journal of Neurology, 2018, 51(9): 666-682. doi: 10.3760/cma.j.issn.1006-7876.2018.09.004
    [5]
    李宏建. 发病前改良Rankin量表评分3分和4分的卒中患者血栓切除术后的临床转归[J]. 国际脑血管病杂志, 2019, 27(3): 186.

    LI H J. Clinical outcomes after thrombectomy in stroke patients with pre-onset modified Rankin scale scores of 3 and 4[J]. International Journal of Cerebrovascular Diseases, 2019, 27(3): 186.
    [6]
    李莹. 不同严重程度及时间窗的急性缺血性脑卒中患者静脉溶栓的预后研究[D]. 天津: 天津医科大学, 2020.

    LI Y. The prognosis of acute ischemic stroke patients with different severity and time window after intravenous thrombolysis[D]. Tianjin: Tianjin Medical University, 2020.
    [7]
    朱衡亚, 孙晓燕, 胡正刚, 等. 脑梗死后血管性认知功能损害与rt-PA静脉溶栓的相关性[J]. 中华全科医学, 2020, 18(6): 962-964. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202006021.htm

    ZHU H Y, SUN X Y, HU Z G, et al. Relationship between vascular cognitive impairment after cerebral infarction and intravenous thrombolysis by rt-PA[J]. Chinese Journal of General Practice, 2020, 18(6): 962-964. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202006021.htm
    [8]
    SCHELLINGER P D, KÖHRMANN M. Intravenous thrombolytic therapy remains the basis and mainstay of revascularizing therapy[J]. Stroke, 2018, 49(10): 2285-2286. doi: 10.1161/STROKEAHA.118.022620
    [9]
    GU H Q, YANG X, WANG C J, et al. Clinical characteristics, management, and in-hospital outcomes in patients with stroke or transient ischemic attack in China[J]. JAMA Netw Open, 2021, 4(8): e2120745. DOI: 10.1001/jamanetworkopen.2021.20745.
    [10]
    BRAEMSWIG T B, VILLRINGER K, TURC G, et al. Predictors of new remote cerebral microbleeds after IV thrombolysis for ischemic stroke[J]. Neurology, 2019, 92(7): e630-e638.
    [11]
    ZHENG H G, YANG Y, CHEN H S, et al. Thrombolysis with alteplase 3-4.5 hours after acute ischaemic stroke: the first multicentre, phase Ⅲ trial in China[J]. Stroke Vasc Neurol, 2020, 5(3): 285-290. doi: 10.1136/svn-2020-000337
    [12]
    FAN Y, LIAO X L, PAN Y S, et al. Intravenous thrombolysis is safe and effective for the cryptogenic stroke in china: data from the thrombolysis implementation and monitor of acute ischemic stroke in China (TIMS-China)[J]. J Stroke Cerebrovasc Dis, 2019, 28(1): 220-226. doi: 10.1016/j.jstrokecerebrovasdis.2018.09.041
    [13]
    WARACH S J, DULA A N, JR MILLING T J. Tenecteplase thrombolysis for acute ischemic stroke[J]. Stroke, 2020, 51(11): 3440-3451. doi: 10.1161/STROKEAHA.120.029749
    [14]
    BALAMI J S, WHITE P M, MCMEEKIN P J, et al. Complications of endovascular treatment for acute ischemic stroke: prevention and management[J]. Int J Stroke, 2018, 13(4): 348-361. doi: 10.1177/1747493017743051
    [15]
    周准. 3-4.5 h时间窗急性缺血性脑卒中rt-PA静脉溶栓临床分析[D]. 福州: 福建医科大学, 2017.

    ZHOU Z. Clinical analysis of rt-PA intravenous thrombolysis in acute ischemic stroke with 3-4.5 h time window[D]. Fuzhou: Fujian Medical University, 2017.
    [16]
    QIU L L, FU F W, ZHANG W Y, et al. Prevalence, risk factors, and clinical outcomes of remote intracerebral hemorrhage after intravenous thrombolysis in acute ischemic stroke: a systematic review and meta-analysis[J]. J Neurol, 2023, 270(2): 651-661. doi: 10.1007/s00415-022-11414-2
    [17]
    沈芳, 沈红健, 邢鹏飞, 等. 阿替普酶静脉溶栓治疗急性心源性缺血性脑卒中的预后影响因素分析[J]. 第二军医大学学报, 2018, 39(9): 1028-1033. https://www.cnki.com.cn/Article/CJFDTOTAL-DEJD201809021.htm

    SHEN F, SHEN H J, XING P F, et al. Prognostic factors of acute cardiogenic ischemic stroke patients treated with alteplase intravenous thrombolysis[J]. Academic Journal of Second Military Medical University, 2018, 39(9): 1028-1033. https://www.cnki.com.cn/Article/CJFDTOTAL-DEJD201809021.htm
    [18]
    SHABAN A, LEIRA E C. Neurologic complications of heart surgery[J]. Handb Clin Neurol, 2021, 177: 65-75.
    [19]
    WU Z M, ZENG M Y, LI C, et al. Time-dependence of NIHSS in predicting functional outcome of patients with acute ischemic stroke treated with intravenous thrombolysis[J]. Postgrad Med J, 2019, 95(1122): 181-186. doi: 10.1136/postgradmedj-2019-136398
    [20]
    尹小燕, 罗国刚, 康丽, 等. 心房颤动对急性缺血性脑卒中溶栓后出血转化的影响[J]. 中国临床神经科学, 2019, 27(1): 22-28. https://www.cnki.com.cn/Article/CJFDTOTAL-LCSK201901004.htm

    YIN X Y, LUO G G, KANG L, et al. The Effects of Atrial Fibrillation on Hemorrhagic Transformation after Thrombolysis in Acute Ischemic Stroke[J]. Chinese Journal of Clinical Neurosciences, 2019, 27(1): 22-28. https://www.cnki.com.cn/Article/CJFDTOTAL-LCSK201901004.htm
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