Correlation Between The Efficacy Of Intravenous Thrombolysis With Different Dosage Rt-PA And The Degree Of The Baseline Neurological Function Defect In Patients With Acute Ischemic Stroke

Objective:To investigate the correlation between the efficacy and safety of intravenous thrombolysis with different dosage rt-PA and the degree of the baseline neurological function defect in patients with acute ischemic stroke.Method:Total113patients with acute ischemic stroke were be enrolled in this study from7hosipitals in suzhou from January2010to January2012.All patients accepted intravenous thrombolysis after stroke,68(60.2%) patients were male,45(39.8%) patients were female. The average age of patients were64.49±12.59years old. According to the body weight and the dosage of rt-PA of patients,these patients were divided into the standard dosage group (≥0.8mg/kg,≤0.9mg/kg) and low dosage group (≥0.6mg/kg,<0.8mg/kg).51(45.1%)patients were divided into standard group and62(54.9%)patients were in low dosage group.According to the baseline neurological functional defect(NIHSS) of patients, thses patients were divided into three groups (groupl:NIHSS0-8; group2:NIHSS9-16; group3:NIHSS17-24).The improved Rankin score (mRS) and the total mortality at3month follow-up period were used as the efficacy index of intravenous thrombolysis. Intracranial hemorrhage (ICH)、symptomatic intracranial hemorrhage(SICH) and other bleeding complications in24hours after the intrvenous thrombolysis were used as the safety index. Investigate wether there is difference in the clinical efficacy and safety between the low dosage group and the standard dosage group, then investigate wether the difference is related to the baseline neurological defect.Results:There are no significant differences in functional independence (mRS0-1)(40.3%vs45.1%,P=0.609)、incidence of intracranial hemorrage(ICH)(14.5%vs19.6%,P=0.471)、incidence of symptomatic intracranial hemorrage(SICH)(8.1%vs 11.8%,P=0.509)、incidence of other bleeding complications(8.1%vs13.7%,P=0.331) and the total mortality (17.7%vs9.8%, P=0.228) between the low dosage group and the standard dosage group.Along with the increasing of the baseline neurological functional defect,the incidence of functional independence (mRS) step down (NIHSS0-8:85.7%, NIHSS9-16:41.4%, NIHSS17-24:6.7%,P=0.000), the incidence of intracranial hemorrage(ICH)(NIHSSO-8:0.0%, NIHSS9-16:19.6%, NIHSS:17-24:26.7%, P=0.020) and the mortality (NIHSS0-8:3.7%, NIHSS9-16:7.1%, NIHSS17-24:36.7%, P=0.000) gradually heighten. In different baseline neurological functional defect groups,there are no significant differences in the incidence of functional independence (mRSO-1)(NIHSS0-8:81.3%vs90.9%, P=0.624; NIHSS9-16:41.4%vs40.7%, P=0.961; NIHSS17-24:0.0%vs15.4%, P=0.179)、the incidence of symptomatic intracranial hemorrhage(SICH)(NIHSS0-8:0.0%vs0.0%;NIHSS9-16:10.3%vs14.8%, P=0.700; NIHSS17-24:11.8%vs15.4%,P=1.000)、the total mortality (NIHSS0-8:6.3%vs0.0%, P=1.000; NIHSS9-16:6.9%vs7.4%, P=1.000; NIHSS17-24:47.1%vs23.1%, P=0.259) between the low dosage group and the standard dosage group.Conclusion:There are similar clinical efficacy and safety between the low dosage rt-PA group and the standard dosage rt-PA group in patients who were accepted intravenous thrombolysis, and there are no correlation between the efficacy and safety of intravwnous thrombolysis in different dosage rt-PA group and the baseline neurological defect degree.