A pilot study of different thrombolytic therapies for acute cerebral infarction due to occlusion of middle cerebral artery / 中华放射学杂志

ABSTRACT

ObjectiveTo evaluate the effect and safety of different thrombolytic therapies for acute cerebral infarction due to occlusion of middle cerebral artery(MCA).MethodsOne hundred and thirty-two cases of acute cerebral infarction in territory of MCA were randomly divided into 3 groups,all of which were treated with alteplase.Group A (48 cases) was treated by intra-venous therapy with alteplase,group B (43 cases) was treated by infusing alteplase at the site of the internal carotid artery,and group C(41 cases) was treated by infusing alteplase into the thrombus.The improvement of neurological function,complications and mortality rate were recorded and statistically compared,with analysis of variance for counting data of normal distribution,x2 test for quantitative data,and the mean difference was significant at the 0.05level.ResultsThe effective rates of group A,B and C at 2 h,24 h,2 w were 18.8％ (9/48),39.6％ ( 19/48),45.8％ (22/48) ;39.5％ (17/43),53.5％ (23/43),58.1％ (25/43) ;78.0％ (32/41),85.4％ (35/41 ),87.8％ (36/41)respectively.The effective rate of group C was obviously better than group A( x2 =12.809,9.979,9.289,P ＜ 0.01 ) and B (x2 =31.295,19.425,17.161,P ＜ 0.01 ) with statistical significance.The effective rate of group B was better than group A at 2 h after thrombolytic therapy with statistical significance (x2 =4.801,P ＜ 0.05 ).The effective rate of group A and B did not have significant difference at 24 h,2 w after therapy ( x2 =1.765,1.375,P ＞ 0.05 ).The hemorrhage rates of group A,B and C were 14.6％ (7/48),14.0％ (6/43),7.3％ (3/41 ),the mortality rates of group A,B and C were 6.2％ (3/48),4.6％ (2/43),2.4％ (1/41),and there was no significant difference among the 3 groups ( x2 =1.328,0.786,P ＞ 0.05 ).ConclusionIt is suggested that the thrombus-imbeded thrombolytic therapy is a better way in treating acute cerebral infraction due to occlusion of MCA for its rapid and better therapeutic effect.