Correlation Study Of Multi-mode CT-based Intravenous Thrombolysis And Hemorrhagic Transformation In Ischemic Stroke Patients

Research objective:To compare the safety of intravenous thrombolytic therapy with recombinant tissue plasminogen activator(rt-PA) of cerebral infarction under the guidance of time-window and multi-modal CT Method:According to the inclusion standard,97patients who received intravenous rt-PA therapy from October2010to January2014were collected. hemorrhagic transformation was assessed by CT performed at24h after treatment or sympotamatic deterioration within24h. The clinical, laboratory, and radiologic data were analysised. Blood samples were collected before thrombolysis and24h,3d,7d after the thrombolysis. The serum MMP-9levels of out-patient healthy subjects served as basal line deference. The serum MMP-9expression was measured by ELISA. Results:Among97patients treated with intravenous rt-PA, patients with hemorrhagic transformation was found in24patients (24.7%), symptomatic ICH occurred in6patients (6.1%). Compared to patients under the guidance of multi-modal CT and patients under time-window:There were7cases with HT in multi-modal CT-group and17cases with HT in time-window-group, the difference of the two group was significant (P<0.05). The expression of serum MMP-9at different perieods in the two-group patients was higher than the basal line and the highest level was on24h after thrombolysis. As compared to patients without HT, patients with HT had higher MMP-9expression, the difference of the two group was significant (P<0.05). The expression of serum MMP-9in patients with HT in time-window group was higher than patients with HT in multi-modal CT group at24h and7d after the thrombolysis. the difference was significant. Conclusion:The risk of hemorrhagic transformation is lower in patients receiving intravenous thrombolytic therapy with rt-PA guided by multi-mode CT than those guided by time-window. Patients with infarction had a higher MMP-9expression. The level of the MMP-9can predict the efficacy of thrombolysis therapy in patients with acute cerebral infarction. Patients with IP had a lower MMP-9expression at24h and7d after the thrombolysis than patients without IP.