Analysis of the safety and efficacy of intravenous thrombolysis in expanded time window in acute ischemic stroke under the guidance of F-stroke software
Objective To investigate the safety and efficacy of intravenous thrombolysis guided by F-stroke software based on computed tomography perfusion(CTP)in patients with acute ischemic stroke with an onset of 4.5-9.0 h and analyze the factors affecting patients'prognosis.Methods A retrospective analysis was conducted on patients with acute ischemic stroke with an onset of 4.5-9.0 h,and brain CTP examination and F-stroke software were completed for post-image analysis.The patients were divided into a treatment group(51 cases)and a control group(57 cases)according to whether they were given intravenous thrombolysis or not.The treatment group was given intravenous thrombolysis,followed by oral antiplatelet aggregation drugs[no hemorrhagic transformation(HT)24 h after thrombolysis],statin drugs,and intravenous butylphthalide injection,edaravone and dextranol treatment.The control group was treated with oral antiplatelet aggregation drugs,statin drugs,intravenous butylphthalide injection,edaravone and dextranol.Comparison was made on clinical data and the analysis results of F-stroke software were compared,including hypoperfusion volume(VTmax＞4 s,VTmax＞6 s,VTmax＞8 s and VTmax＞10 s)with peak time of＞4 s,＞6 s,＞8 s,and＞10 s,infarct core volume(VCBF＜30%)and the mismatch volume.The National Institutes of Health Stroke scale(NIHSS)score,modified Rankin scale(mRS)score at different times,long-term prognosis and the incidence of HT at 24-36 h after stroke were compared between the two groups.The factors influencing the prognosis of acute ischemic stroke treated with intravenous thrombolysis in expanded time window were analyzed.Results The VTmax＞4 s in the F-stroke software analyzed results of the treatment group[(157.43±137.18)ml]was greater than that of the control group[(107.56±107.26)ml],and the difference was statistically significant(P＜0.05).The NIHSS score at 7 d after stroke in the treatment group was(4.04±5.18)points,which was lower than(6.00±4.41)points at baseline,and the difference was statistically significant(P＜0.05).The mRS scores at 90 d after stroke in both groups were lower than those at admission,and the difference was statistically significant(P＜0.05).There was no significant difference in baseline NIHSS score,NIHSS score at 7 d after stroke,mRS score at admission and mRS score at 90 d after stroke between the two groups(P＞0.05).The rate of good long-term prognosis in the treatment group was slightly higher than that in the control group,but the difference was not statistically significant(P＞0.05).There was no statistically significant difference in the incidence of HT at 24-36 h after stroke between the two groups(P＞0.05).No symptomatic intracranial hemorrhage(SICH)occurred in both groups.Binary Logistic regression analysis showed that mRS score was an influential factor for prognosis of patients with intravenous thrombolysis in expanded time window(P＜0.05).The model formula was obtained:ln(p/1-p)=7.840-2.111×mRS score at admission(where p represents the probability of good prognosis and 1-p represents the probability of poor prognosis).Conclusion Through the screening of F-stroke software based on CTP,it is safe and may be effective to extend the time window of intravenous thrombolysis(4.5-9.0 h),which is worthy of further study and verification.
Computed tomography perfusionF-stroke softwareAcute ischemic strokeIntravenous thrombolysisExpanded time window
万方数据
维普
