The timing of low-dose rt-PA intravenous thrombolysis combined with edaravone dexborneol in the elderly patients with moderate to severe acute ischemic stroke
Objective To explore at different times the efficacy and safety for recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis combined with edaravone dexborneol in the elderly patients with moderate to severe acute ischemic stroke(AIS),and provide the reference for clinic treatment of AIS.Methods From November 2020 to May 2023,181 elderly patients(≥80 years old)with moderate or severe AIS treated with low-dose rt-PA(0.6 mg/kg)intravenous thrombolysis in the emergency department stroke center of the Fourth central hospital were selected as the subjects.According to the treatment method,the subjects were divided into control group(60 cases,received intravenous thrombolytic therapy with rt-PA),early combined group(61 cases,intravenous edaravone dexborneol was started during rt-PA),late combined group(60 cases,intravenous thrombolysis of rt-PA for 24 h,then treated with edaravone dexborneol).The neurological improvement rate of 7 d,good prognosis rate of 90 d,intracranial hemorrhage rate,symptomatic intracranial hemorrhage rate,extracranial systemic complications rate and 90 d mortality rate were compared in 3 groups.One-way analysis of variance,Mann-Whitney U test and x2 test were used to analyze the data.The used software was SPSS 22.0.Results The neurologic improvement rate(21.3％)at 7 days and good prognosis rate(49.2％)at 90 days of the early combined group were better than those(6.7％and 20.0％)of the control group and those(13.3％and 40.0％)of the late combined group(P＜0.05).The intracranial hemorrhage rate(4.9％)and symptomatic intracranial hemorrhage rate(1.6％)in the early combined combined group were lower than those(11.7％and 6.7％)in the control group and those(10.0％and 5.0％)in the late combined group(P＜0.05).The extracranial systemic complication rate(8.2％)in the early combined group was significantly lower than that(13.3％)in the late combined group(P＜0.05).The mortalities(6.6％)within 90 days of early combined group was significantly lower than that(21.7％)of control group and that(13.3％)of the late combined group(P＜0.05).Conclusion After rt-PA intravenous thrombolysis,the immediate application of edaravone dexborneol can increase the the efficacy and safety of rt-PA intravenous thrombolysis in elderl patients with moderate to severe AIS.
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