| Objective: 1. To observe the curative effect and safety of recombinant tissue plasminogen activator(rt-PA)on acute ischemic stroke patients(AIS)who are under antiplatelet therapy.2. To compare short-term effects, clinical prognosis and intracranial hemorrhage rate, mortality rate of the prior use of dual antiplatelet drugs and the prior use of single antiplatelet drug for patients with intravenous thrombolysis.3. To compare short-term effects, clinical prognosis and intracranial hemorrhage rate, mortality rate of the prior use of aspirin and the the prior use of clopidogrel for patients with intravenous thrombolysis.Methods: 1. 233 AIS patients admitted between April 2014 to October 2015 at Tianjin Huanhu Hospital were included into the study. The patients were divided into different groups according to the previous use of antiplatelet drugs. These groups included antiplatelet drugs group with 109 patients and unantiplatelet drugs group with 124 patients. Antiplatelet drug group was divided into dual antiplatelet drugs group with 23 patients and single antiplatelet drug group with 86 patients. Single antiplatelet drug group included aspirin group having 57 patients and clopidogrel group having 29 patients. They all accepted the intravenous thrombolytic treatment within 4.5 hours form onset. The age of all patients was 18-80 years old.2. We recorded the baseline characteristics(age, gender, history, onset to treatment time, admission NIHSS score, risk factors), NIHSS scores after the treatment of 24 hours, 7days and the modified Rankin Scale(m RS)score at 90 day of all the patients. The intracranial hemorrhage rate and mortality rate were also recorded.3. Short-term clinical outcome was assessed using the score of NIHSS. Good prognosis in short time was defined as NIHSS score was 0 or decreased more than or equal to 4 points compared with the NIHSS score at admission. Long-term clinical outcome was assessed using m RS score at 90 day and was dichotomized into favorable(m RS 0-2) versus unfavorable(m RS 3-6).Results: 1. All the baseline characteristics including age, gender, history, onset to treatment time, admission NIHSS score, risk factors, admission laboratory indicators and TOAST classification are not different in all the comparison groups.2. Short-term clinical outcome(24h,7d) were significant different between antiplatelet drug group and unantiplatelet drugs group(P=0.039, P=0.016). At 90 days, the clinical prognosis of the two groups have significant difference(P=0.041).The rate of intracranial hemorrhage rate and mortality rate were not different in the two groups.3. Short-term clinical outcome(24h,7d) were not different between single drug group and dual drugs group(P=0.213, P=0.189). At 90 days, the clinical prognosis of the two groups have no difference(P=0.555). The rate of intracranial hemorrhage rate and mortality rate were not different in the two groups(P>0.05).4. Short-term clinical outcome(24h,7d) were not different between asplin group and clopidogrel group(P=0.915, P=0.775). At 90 days, the clinical prognosis of the two groups have no difference(P=0.528).The rate of intracranial hemorrhage rate and mortality rate were not different in the two groups(P>0.05).Concludion: 1. Intravenous rt-PA thrombolytic therapy is effective and safe for AIS who are under antiplatelet treatment. These patients could achieve better Short-term clinical outcome and clinical prognosis than unantiplatelet drug group through thrombolytic therapy.2. The prior use of aspirin or clopidogrel alone and the use of aspirin and clopidogrel had no different effect on hemorrhage rate, mortality rate and short-term clinical outcome, clinical prognosis of intravenous thrombolysis.3. The prior use of aspirin and the use of clopidogrel had no differenct effect on hemorrhage rate, mortality rate and short-term clinical outcome, clinical prognosis of intravenous thrombolysis. |
