ABSTRACT
Objective To evaluate the efficacy and safety of alteplase (rt-PA) thrombolytic therapy on patients with acute ischemic stroke aged over 80 years old.Methods The observational cohort study were conducted.One hundred and thirty-six patients with acute cerebral infarction and received rt-PA thrombolytic treatment were selected as our subjects with incidence time of 4.5 h,and the rt-PA dose of 0.9 mg/kg.The patients were divided into ≥80 years old group(n =34) and ＜80 years old group(n =102).U.S.A national institutes of health stroke scale (NIHSS) score of two groups evaluated before thrombolysis,immediately after thrombolysis 24 h,7 d and 14 d.The incidence and mortality rate of intracranial hemorrhage (ICH) and symptomatic intracranial hemorrhage (sICH) of two group were compared; and the score of modified Rankin's Scale (mRS) followed-up of 90 d were evaluated.Results NIHSS score after thrombolysis 24 h,7 d and 14 d of two groups were significantly lower than that before thrombolysis,and the differences were statistically significant (t =4.123,9.936,9.679,5.657,8.154,6.956,P ＜0.01).The score after thrombolysis 24 h,7 d and 14 d of two groups were no statistically significant difference.The efficient rate of treatment of two group were 55.88％ and 61.76％ respectively(P =0.54).Mter follow-up of 90 d,the prognosis rate were 47.06％ and 64.71％ respectively(P =0.07),and there were no statistically significant difference.Incidence rate of ICH were 11.76％ and 5.88％ respectively(P =0.07).Occurrence rates of sICH were 5.88％ and 2.94％ (P =0.43).Mortality rate were 11.76％ and 9.80％ (P =0.33),and there were no statistically significant difference.Conclusion This study shows that 80 years of age or older patients with acute ischemic cerebral apoplexy patients using rt-PA intravenous thrombolytic therapy is safe and effective,but RCT need further study.
ABSTRACT
Objective To observe the status and effects of the social support on rehabilitation in stroke patients.Method Personal resource Questionnaire(PRQ) were compared 198 stroke patients with 200 healthy persons,assessed neurological functional defect and Activities of Daily living(ADL) of stroke patients,when they were discharged and after two months.To observed relationship between social support and effects of rehabilitation.Result The social support scores in stroke patients were lower than those in healthy ones(P<0.01).Neurological functional defect and ADL scores were increased over the social support scores(P< 0.01).Conclusion To strengthen social support could promote rehabilitation of stroke patients.