Effect Of Intravenous Thrombolysis With Rt-PA In The Treatment Of Acute Mild Cerebral Infarction And Predictive Ability Analysis Of IScore And PLAN Scales

ObjetiveTo investigate the efficacy and safety of intravenous thrombolytic therapy with recombinant tissue type plasminogen activator(rt-PA)in patients with acute mild cerebral infarction in Shenyang area,and to explore the predictive ability of ISCore score and PLAN score in 90 days of poor prognosis of patients with intravenous thrombolytic therapy.MethodsThis study screened inpatients from a department of neurology from September2018 to December 2020 in the Central Hospital Affiliated to Shenyang Medical College.The screening criteria are acute mld stroke patients with onset time ≤4.5hours and NIHSS ≤5 points.Strictly screen 76 patients who meet the admission criteria and have no exclusion criteria,and be divided into a thrombolytic group(R group)and a non-thrombolytic group(N group)according to whether rt-PA intravenous thrombolysis treatment was taken at admission;The difference(0-3 hours and 3-4.5 hours)divides the two groups into four subgroups: R1,R2,N1,and N2.The thrombolysis group(group R)was admitted to the hospital immediately.9 mg / kg to calculate the total amount of drug,the maximum dose is 90 mg.First,10% of the total dose of the drug is intravenously injected within 1 minute,and after completion,the remaining 90% is intravenously infused within 1 hour.After 24 hours,it was changed to anti-platelet aggregation,improve cerebral circulation,remove oxygen free radicals,and improve brain function.The non-thrombolytic group(group N)was given anti-platelet aggregation,improved cerebral circulation,scavenged oxygen free radicals,and improved brain function treatment immediately after admission.Strictly record the NIHSS scores of all patients at admission,1 hour of drug treatment,24 hours of drug treatment,7 days of drug treatment,14 days of drug treatment,adverse reactions during medication,mRS scores and blood viscosity(BV)at 90 days after discharge),Plasma viscosity(PV).ResultsThis study,100 patients with acute cerebral infarction were retrospectively analyzed admitted to the emergency room or neurological department of shenyang center hospital affiliated to medical university from October 2018 to December 2020,the onset time in 4.5 hours,and agency()of the national institutes of health stroke scale score of 5 or less,meet the inclusion criteria of this study but does not include exclusion criteria.Patients were divided into experimental group(48 cases)and control group(51 cases)according to whether they voluntarily accepted intravenous thrombolysis.After admission to perfect the basic data collection,fill the NHISS score,1 hours after thrombolysis NHISS points,scored 24 hours after thrombolysis NHISS,NHISS NHISS score after the seven days in hospital and discharged from hospital after scoring 30 days,90 days after discharge NHISS score,score 30 days after hospital discharge,Mrs.Mrs Score 90 days after discharge,1 days later to check the length of the head CT,record the patient bleeding gums,nose bleeding,and black,and so on,the SPSS23.0 statistical software analysis the curative effect of two groups of patients,prognosis and safety;The scores of iScore and Plan were recorded respectively.Receiver operating characteristic curve(ROC)was used to calculate the AUC of the two scales,and the predictive ability of the two scales on prognosis and adverse reactions of patients with thrombolysis was compared.ConclusionsFor patients with mild acute cerebral infarction within 4.5 hours,intravenous rt-PA thrombolytic therapy and double antibody therapy were clinically effective,but the former had a better recovery of neurological function within 24 hours.After 90 days of intravenous thrombolytic treatment with TS-PA,patients with mild acute cerebral infarction had a better prognosis than those without thrombolytic treatment.After thrombolytic therapy,the planning scale was superior to the iScore scale in patients with acute mild cerebral infarction.