Effectiveness and prognosis-related factors of intravenous thrombolysis in patients with acute ischemic stroke

GENG Jieli; SONG Yeping; JIN Haifeng; CHEN Ying; LIN Yan; SUN Yameng; PAN Yuanmei; YU Ling; SHI Guowen; XU Qun

doi:10.12022/jnnr.2016-0032

Journal of Neurology and Neurorehabilitation ›› 2016, Vol. 12 ›› Issue (3) : 123-130. DOI: 10.12022/jnnr.2016-0032

Original Research

Effectiveness and prognosis-related factors of intravenous thrombolysis in patients with acute ischemic stroke

GENG Jieli, SONG Yeping, JIN Haifeng, CHEN Ying, LIN Yan, SUN Yameng, PAN Yuanmei, YU Ling, SHI Guowen, XU Qun

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Abstract

Objective: Intravenous thrombolysis is the most effective therapy that guidelines have recommended for treating acute ischemic stroke. This study aims to evaluate the factors related to the clinical outcomes in patients with acute ischemic stroke receiving intravenous thrombolysis. Methods: This study recruited 136 patients with acute ischemic stroke treated with intravenous recombinant tissue plasminogen activator (rt-PA). The demography, vascular risk factors and the characteristics of acute ischemic stroke were recorded. The early improvement which was defined as complete resolution of the neurologic deficit or an improvement from baseline in the score on the National Institute of Health Stroke Scale (NIHSS) 24 hours after intravenous thrombolysis and the independent functional outcomes which was defined as a score of 0 or 1 on the modified Rankin scale (mRS) three months after the onset of stroke were evaluated. The factors related to early improvement and late independent functional outcomes were examined by univariate and multivariate analyses. Results: Sixty-six patients (48.5%) achieved early improvement and 64 patients (47.1%) achieved late independent functional outcomes. The early efficacy 2 hours, 24 hours and 7 days after intravenous thrombolysis had relevance to the later prognosis (all P < 0.05). Lower systolic pressure was independently associated with better early improvement (P < 0.05). Conclusion: Decrease in systolic blood pressure before intravenous thrombolysis may promote the early improvement in patients with acute ischemic stroke. The early response to intravenous thrombolysis may predict the late outcomes.

Key words

Acute ischemic stroke / Intravenous thrombolysis / Prognosis

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GENG Jieli, SONG Yeping, JIN Haifeng, CHEN Ying, LIN Yan, SUN Yameng, PAN Yuanmei, YU Ling, SHI Guowen, XU Qun. Effectiveness and prognosis-related factors of intravenous thrombolysis in patients with acute ischemic stroke[J]. Journal of Neurology and Neurorehabilitation. 2016, 12(3): 123-130 https://doi.org/10.12022/jnnr.2016-0032

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