Analysis of short ⁃ term effects of rt ⁃ PA intravenous thrombolysis in patients with acute ischemic stroke in different age groups

Abstract

Objective To determine if rt ⁃ PA intravenous thrombolysis has distinct short ⁃ term effects on individuals of different ages with acute ischemic stroke. Methods Seventy acute ischemic stroke patients admitted to Dongcheng Branch of The First Affiliated Hospital of Anhui Medical University from March 2018 to November 2021 were included, and were divided into an eld age group (≥ 70 years old, n = 38) and non⁃eld age group (< 70 years old, n = 32), and all received standard dose rt⁃PA intravenous thrombolysis at the time of admission and 2 h, 24 h and 7 d after thrombolysis, respectively. Neurological function was evaluated by National Institutes of Health Stroke Scale (NIHSS) at admission, and 2 h, 24 h and 7 d after thrombolysis. The prognosis was evaluated by modified Rankin Scale (mRS) before and 7 d after thrombolysis. Results There were significant differences in NIHSS (F = 12.555, P = 0.001) and mRS (F = 13.927, P = 0.004) scores before and after thrombolysis in different age groups, in which there was a significant group × time interaction effect in NIHSS score in 2 groups (F = 3.847, P = 0.010), but no interaction for mRS score (F = 0.646, P = 0.424). The NIHSS score after thrombolysis at 2 h (t = 7.506, P = 0.000; t = 6.391, P = 0.000), 24 h (t = 9.982, P = 0.000; t = 6.391, P = 0.000) and 7 d (t = 12.691, P = 0.000; t = 9.942, P = 0.000) were lower than those before thrombolysis in 2 groups, the NIHSS score at 7 d after thrombolysis was also lower than that of 2 h after thrombolysis (t = 5.185, P = 0.000; t = 3.551, P = 0.003) and 24 h after thrombolysis (t = 2.708, P = 0.043; t = 3.551, P = 0.003). The mRS score at 7 d after thrombolysis was also lower than that of before thrombolysis in 2 groups (P = 0.004). At 2 h, 24 h and 7 d after thrombolysis, there was no statistically significant difference in the rate of total effect (NIHSS score improvement rate ≥ 30%) between 2 groups [53.13% (17/32) vs. 47.37% (18/38), χ2 = 0.461, P = 0.794; 75% (24/32) vs. 55.26% (21/38), χ2 = 2.949, P = 0.229; 81.25% (26/32) vs. 65.79% (25/38), χ2 = 3.061, P = 0.216]. The rate of favorable prognosis (mRS score 1-2) at discharge was more significant in the non⁃eld age group than in the eld age group [87.50% (28/32) vs. 57.89% (22/38); χ2 = 6.080, P = 0.014]. There were no fatalities in 2 groups, and the frequency of cutaneous, oral and gingival bleeding within 48 h after thrombolysis in eld age group was more common than in non⁃eld age group [23.68% (9/38) vs. 6.25% (2/ 32); χ2 = 3.986, P = 0.046]. Conclusions Patients with acute ischemic stroke in different age groups benefited from rt ⁃ PA intravenous thrombolysis, and the younger patients saw quicker, more noticeable improvements and fewer adverse effects.

DOI: 10.3969/j.issn.1672⁃6731.2023.06.015