Differences In The Effects Of Intravenous Thrombolysis And Mechanical Thrombectomy On Microbleeds And Cognitive Function In Patients With Acute Cerebral Infarction

Objective: Intravenous thrombolysis and mechanical thrombectomy are the first choice for the treatment of acute cerebral infarction.Their safety and effectiveness have been widely recognized,but further studies are needed to address possible vascular endothelial damage and increased microbleeds after treatment.We use Susceptibility-weighted imaging(SWI)to study the impact of intravenous thrombolysis and mechanical thrombectomy on acute cerebral infarction patients,focused on cerebral microbleeds(CMBs),cognitive function,and clinical bleeding events,in order to provide a basis for optimizing clinical treatment and decision-making in the later period.Methods: Cerebral infarction patients,who were admitted to the Neurology ward of Tongji Hospital of HUST from June 2018 to September 2019,were included.During the 180-day follow-up,changes in microbleeds,cognitive function score(MMSE,Mo CA scale),and neuroloical deficits scores(NIHSS,m RS scale)were observed,and clinical bleeding events were also collected during the follow-up.A total of 117 patients were followed up,including 40 patients in the intravenous thrombolysis group,26 patients in the mechanical thrombectomy group,and 51 patients in the conventional treatment group.Result:Compared with the subgroups with or without microbleeds,through the chi-square test,smoking and hypertension were found to be risk factors for microbleeds(P <0.05).Logistics analysis found that hypertension was an independent risk factor(P <0.05).The location of microbleeds of the three groups were counted.Chi-square test showed that there were significantly more microbleeds in the basal ganglia area(P <0.05).Compared with the intravenous thrombolysis group,patients in the mechanical thrombectomy group showed higher risks of increased microbleeds and neurological hemorrhage events.The chi-square test was statistically significant(P <0.05).Compared with the intravenous thrombolysis group,the MMSE and Mo CA scores of the mechanical thrombectomy group showed a more obvious ascending trend,and there was no statistical significance by rank sum analysis(P> 0.05);the NIHSS and m RS scores of the mechanical thrombolysis group had a more obvious descending trend,and there was statistical significance by rank sum analysis(P <0.05).Compared with the non-microbleeds subgroup,the ascending trend of MMSE and Mo CA scores in patients with microbleeds subgroup were more obvious,and there was no statistical significance by rank sum analysis(P> 0.05).The descending trend of NIHSS and m RS scores in patients without microbleeds were more obvious than the subgroup with microbleeds,and there was statistically significant by rank sum analysis(P <0.05).Conclusion:1.Hypertension is an independent risk factor for cerebral microbleeds in acute cerebral infarction patients.2.In acute cerebral infarction patients,cerebral microbleeds are more common in the basal ganglia area.3.Compared with intravenous thrombolysis,patients with mechanical thrombectomy showed increased microbleeds and a higher risk of neurological bleeding,but there is no significant difference in the effect on cognitive function.4.For patients treated with intravenous thrombolysis and mechanical thrombectomy,the presence of microbleeds affects the recovery of neurological deficits of acute cerebral infarction patients,but has no significant effect on cognitive function.5.Compared with intravenous thrombolysis,mechanical thrombectomy can significantly reduce neurological deficits.