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Objective To evaluate the value of MR angiography in thrombolytic therapy of acute ischemic stroke. Methods According to inclusion criteria, 65 patients who also having large vessel occlusion were selected, and they were performed rt-PA treatment (38 patients) and routine treatment (27 patients) within 3-6 hours of onset of symptoms, respectively. Mann-Whitney U test and chi square test were performed to compare the clinical and MR imaging baseline index and the clinical outcome between the two groups respectively. Clinical outcome was assessed after 3 months using a dichotomized modified Rankin scale score.Data were also compared with the combined analysis of the ATLANTIS, ECASS, NINDS rt-PA trials. Resets The difference of clinical outcome in 3 months between the two groups was significant (P < 0. 05) and the median of the two group was 1 and 3, respectively. The ratio of favorable outcome (mRS 0-1) in the two groups was 52. 6% (20/38) and 33.3% (9/27), respectively. Conclusion MR angiography plays an important role in thrombolytic therapy of acute ischemic stroke and it should be used to consummate the conventional inclusion criteria, the patients with large vessel occlusion should be treated by rt-PA.
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Objective To study the accuracy of plasma matrix metalloproteinase-9 (MMP-9) predicting hemorrhagic transformation (HT) in ischemic stroke. Methods The studies on plasma MMP-9 predicting HT in ischemic stroke were included, in which diagnostic criteria, methods, and subjects were clearly described, regardless of language of publication and type of studies. MEDLINE (Apr, 1966 to 2006), EMBase (Apt, 1966 to 2006), CNKI (Feb, 1977 to 2006), and wanfangshuju (1989 to 2005) were searched and the references lists of eligible studies were manually searched. Two reviewers independently evaluated the quality of studies and extracted data. The data were analyzed using the Revman 4. 2 or SPSS 11.0. Results Five trials including 497 patients fulfilled the inclusion criteria, 109 of the 497 patients developed HT. The heterogeneity among studies was great (xspecialty 89. 9% (95% CI: 86. 4%-93.5%), sensitivity 86. 5% (95% CI: 77. 3%-96. 8%). Conclusions The values of plasma MMP-9 may be an independent predictor of hemorrhagic transformation. The number of patients in the included studies is not large enough, and the results need to be confirmed in further studies.