Efficacy and safety of intravenous thrombolysis with alteplase for the treatment of wake-up ischemic stroke under the guidance of multimode CT

ObjectiveTo study the efficacy and safety of intravenous thrombolysis with alteplase for the treatment of wake-up ischemic stroke(WUIS) under the guidance of multimode CT.

MethodsA total of 28 patients with WUIS who were admitted to the neurology department and given intravenous thrombolysis with alteplase under the guidance of emergency multimode CT(observation group) were prospectively included.At the same time, 30 patients(control group) who were not with WUIS at the same period with time window of contemporaneous onset < 4.5 hours were collected.The coagulation functionprothrombin time(PT), activated partial thromboplastin time(APTT), fibrinogen(Fib), platelet(PLT), high-sensitivity C-reactive protein(hs-CRP), National Institutes of Health stroke scale(NIHSS) score, living ability score(Barthel), clinical efficacy and outcome were compared between the two groups before treatment and 24, 7 and 14 days after treatment.

ResultsThe clinical total effective rate and clinical good outcome rate in the observation group were 78.57% and 75.00%, respectively, and those in the control group were 83.33% and 80.00%, there was no statistical significance between the two groups(P>0.05).After treatment, the levels of Fib, PLT and hs-CRP in the observation group were gradually lower than those before treatment, and the levels of PT and APTT were gradually higher than those before treatment, with statistical significance before and after treatment(P < 0.05).The change trend of the control group was consistent with that of the observation group, but there was no statistical significance at each time point between the two groups(P>0.05).After treatment, the NIHSS score in the observation group decreased gradually and Barthel score increased gradually, which was statistically significant compared with that before treatment(P < 0.05).The change trend of the control group was consistent with that of the observation group, but there was no statistical significance at each time point between the two groups(P>0.05).

ConclusionsEmergency multimode CT can be used as a reliable imaging basis for intravenous thrombolysis in WUIS patients with high efficacy and safety.