Intravenous RtPA Thrombolysis For Acute Cerebral Infarction (within 6 Hour) A Non-randomized And Controlled Clinical Study

Stroke is the third most common cause of death in the world,after myocardial infarction and cancer,and the single most common reason for permanent disability. Up to 85% of all stroke are of ischemic origin and most are the result of blockage of a cerebral artery by a blood clot. After introduction of thrombolytic therapy for the treatment of acute myocardial infarction in the early 1990s,major trials for the evaluation of this new therapeutic approach to ischemic stroke were initiated. In the US and Europe,intravenous rtPA is the recommended treatment for the acute cerebral infarctions. That using rtPA for the treatment of acute cerebral infarctions has been confirmed by FDA. But in china,the research of using rtPA for the therapy of acute ischemic stroke is not much. Objective: To evaluate the efficacy and safety of intravenous rtPA for the therapy of acute cerebral infarctions within 6 hours from symptom onset. Methods: A non-randomized and controlled clinical study was performed. Thirty patients consistent with the thrombolysis group criteria received rtPA 50mg intravenously in one minute. 24 hours after thrombolysis , 100mg aspirin was administered per day. Meliorate Scandinavian Stroke Scale (MESSS) was used to evaluate the neurological deficits and the MESSS scores were recorded on the following time points: pretherapy,2hours,24hours,3days,7days,14days,30days,and 90days after thrombolysis. Thirty patients consistent with the controlled group criteria received routine treatment. 24 hours after entering wards,100mg aspirin was administered per day. Meliorate Scandinavian Stroke Scale (MESSS) was used to evaluate the neurological deficits and the MESSS scores were recorded on the following time points: pretherapy,24hours,3days,7days,14days,30days,and 90days after therapy. All patients received head CT scan or MRI,complete blood count,coagulative time,electrocardiogram before therapy. Results: MESSS scores decreased rapidly after thrombolysis. There was significant difference between 2 groups. One non-symptomatic hemorrhage onset was found. No dead case. Conclusion: rtPA is effective and relatively safe in treatment of acute cerebral infarctions within 6 hours from symptom onset.