Efficacy and safety of intravenous thrombolysis with different doses of rt-PA in the treatment of acute anterior circulation cerebral infarction with atrial fibrillation / 中国生化药物杂志

ABSTRACT

Objective To explore the Efficacy and safety of intravenous thrombolysis with different doses of rt-PA in the treatment of acute anterior circulation cerebral infarction with atrial fibrillation.Methods Retrospective analysis of 61 cases of patients with anterior circulation of cerebral infarction with atrial fibrillation from October 2009 to October 2014 in the First Affiliated Hospital of Xiamen University, the incidence within 4.5 hours of intravenous thrombolysis,and divided into two groups by rt-PA usage,19 cases in adequate group,received 0.9 mg/kg rt-PA intravenous thrombolytic therapy,42 cases in low dose group, received 0.6 mg/kg rt-PA intravenous thrombolysis.Before and after thrombolysis 1,7 and 30 days,NIHSS score was measured, the indexes of coagulation were observed at before thrombolysis and 1,7 days after thrombolysis,,CT scans were performed at 1, 7, and 14 days after thrombolysis,and Rankin (MRS) scores were compared at 90 days after thrombolysis.Results NIHSS 1,7,30 days scores of 2 groups were significantly decreased after thrombolysis(P<0.05),there was no statistically significant at at each time point after thrombolysis.Plasma prothrombin time increased significantly at 1 day and 7 days after thrombolysis,fibrinogen was significantly lower,compared with the low dose group, the difference was significant (P<0.05).There was no significant difference between the two groups in clinical outcome and mortality.The rate of mucosal bleeding in low dose group was lower than that in adequate group (P<0.05).Conclusion Low-dose rt-PA group intravenous thrombolysis with anterior circulation of atrial fibrillation is more safe,can reduce the risk of bleeding, reduce neurological deficits and improve the quality of life of patients.