Study On Efficacy And Safety Of Intravenous Thrombolysis On Light Stroke

Background: Globally,more than 13.7 million people suffer from stroke every year,and 5.8 million people die from stroke every year,of which more than 1 million die from this cause in China every year.Approximately 70% of strokes are ischemic(9.5 million).The mortality rate of stroke varies greatly by ethnicity and geography.The mortality rate for patients with AIS(Acute Ischemic Stroke)was 3.2% at discharge and8.6% at 6 months,similar to previous studies in the Chinese population,but much lower than in Western countries where the mortality rate was 5.6% at discharge and about 20%at 6 months.But stroke rates in China are far higher than in the West,causing more than1 million dies per year.Stroke is a major source of long-term disability or loss of life,and a major medical and economic burden,costing 2%-4% of total global health care costs each year,with developing countries suffering more than 4% of these costs.In china,the average hospital stay of stroke patients exceeds 2 weeks,which is twice that of most Western countries.In 2016,the average hospitalization cost per capita in China was RMB 11216.Purposes: Patients with “mild AIS”(hereafter referred to as “mild stroke”)were treated with rt-PA(recombinant tissue plasminogen activator)intravenous thrombolytic therapy and oral antiplatelet aggregation therapy.The short-term efficacy,long-term good prognosis rate and safety of treatment were compared between the two groups.Method: Inpatients with mild stroke diagnosed in Department of Neurology,Taizhou People’s Hospital from June 2018 to November 2020 were included,and a total of 149 patients who met the criteria were divided into 2 groups,namely the rt-PA group(74 patients)and non-rt-PA group(75 patients).The non-rt-PA group was treated with an antiplatelet agglutination agent(aspirin + clopidogrel).NIHSS at 24 h and 7d after treatment and m RS at 90 d,recurrence rate,symptomatic intracranial hemorrhage rate and mortality rate of each patient were recorded respectively,and the data of the two groups were compared and studied.Result:1.Baseline data: P>0.05 of each index in the both groups showed no statistical difference,indicating that the two groups were comparable.2.NIHSS for 24 hours: 32 patients(43%)were effective in rt-PA group.In the non-rt-PA group,1 was effective(1%).Significant statistical differences were reflected between the two groups(P<0.01).3.NIHSS at 7 days: 35 patients(47%)were effective in rt-PA group.22 patients(29%)were effective in the non-rt-PA group.There was a statistical difference between the two groups(P=0.029).4.m RS for 90d: 70 patients(94.6%)had good prognosis in rt-PA group.53patients(70.7%)had good prognosis in the non-rt-PA group.Significant statistical differences were reflected between the two groups(P<0.01).5.HT: There were 2 patients with HT in the rt-PA group and no patients with bleeding conversion in the non-rt-PA group,and there was no statistical difference between the two groups(P=0.497).6.Recurrence: At 90 days after treatment,1 patients(1.35%)of the rt-PA group recurred.Simikarly,there was 1 relapse(1.33%)in the non-rt-PA group.There was no statistical difference between the two groups(P=1.000).7.Death: At 90 days after treatment,there was no death in the rt-PA group,which was 0%.There was 1 death(1.33%)in the non-rt-PA group,there was no statistically significant different between the two groups(P=1.000).Conclusions: For mild stroke patients within 4.5h of onset,intravenous rt-PA thrombolytic therapy has better short-term efficacy and long-term prognosis,and does not increase the HT at discharge or the mortality within 90 days.However,the efficacy and the prognosis of antiplatelet aggregation drugs are relatively poor.There was no difference in the rate of stroke recurrence within 90 days between the two treatments.