The Impact of Shortening the Door-to-Needle Time for Intravenous Thrombolysis on the Efficacy and Prognosis of Acute Ischemic Stroke Patients
Objective To investigate the impact of shortening the door-to-needle time(DNT)for intravenous thrombolysis on neurological deficits,hemorheology,and prognosis in patients with acute ischemic stroke.Methods A retrospective analysis was conducted on 143 patients with acute ischemic stroke admitted to Guangdong Central Hospital of Reclamation from January 2021 to December 2022.Patients were grouped based on different DNT times for intravenous thrombolysis,with 61 cases in the early group(DNT with 0-59 minutes)and 82 cases in the late group(DNT≥60 minutes).A comparison was made between the two groups in terms of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)scores,NIH stroke scale(NIHSS)scores after treatment,hemorheological indicators before and after treatment,and the evaluation of treatment effects and adverse outcomes at the 90-day follow-up.Results After 6 hours,24 hours,and 7 days of treatment,the APACHEⅡ scores in the early group were(33.95±4.52)points,(22.37±4.01)points,(12.15±2.73)points,the NIHSS scores were(22.98±4.22)points,(16.47±2.61)points,(10.69±2.18)points,the APACHEⅡ scores in the late group were(37.43±5.37)points,(26.85±5.26)points,(17.06±2.96)points,the NIHSS scores were(28.53±5.27)points,(20.05±3.46)points,(14.55±4.37)points.Compared to before treatment,both groups showed a decrease in APACHEⅡ scores,NIHSS scores,and those in the early group were lower than those in the late group,and the differences were statistically significant(P<0.05).The levels of whole blood high shear reduction viscosity(HRV),whole blood low shear reduced viscosity(LRV),plasma viscosity(PV)and fibrinogen(Fib)in the early group after treatment were(3.06±0.81)mPa·s,(7.05±1.01)mPa·s,(1.07±0.21)mPa·s,(2.33±0.53)g/L.The levels of HRV,LRV,PV and Fib in the late group were(4.21±1.04)mPa·s,(10.14±1.32)mPa·s,(1.53±0.32)m Pa·s and(4.11±0.88)g/L.The levels of hemorheological indexes in the early group were lower than those in the late group,and the differences were statistically significant(P<0.05).The total effective rate of the early group was 96.72％,which was higher than that of the late group(86.59％),and the incidence of cerebral hemorrhage and recurrent stroke was 0 and 1.64％on the 90-day follow-up,lower than 7.32％and 12.20％in the late group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the mortality rate between the two groups(P>0.05).Conclusion Shortening the DNT for patients with acute ischemic stroke can significantly alleviate the severity of the disease and the degree of neurological functional impairment,improve hemorheological indicators,enhance treatment effects,reduce the occurrence of adverse outcomes during follow-up,and achieve satisfactory results.
万方数据
维普
