The Effect of Different Doses of Alteplase on Cognitive Function,Serum D-D,and PLT in Patients with Acute Ischemic Stroke
Objective:To investigate the effects of different doses of Alteplase on platelet count(PLT),D-dimer(D-D)and cognitive function in patients with acute ischemic stroke.Method:A total of 72 patients with acute ischemic stroke admitted to Ruijin People's Hospital from March 2020 to November 2022 were selected,they were randomly divided into a standard dose group(n=36)and a low dose group(n=36),both groups were treated with Alteplase,the dose was 0.9 mg/kg and 0.6 mg/kg,respectively.The neurologic impairment and cognitive function,cerebral circulation dynamics index,platelet parameter and serum index level were compared between the two groups.Result:There was no significant difference in clinical total effective rate between the two groups(P>0.05).After treatment for 1,7,14 and 28 d,the scores of national institute health stroke scale(NIHSS)in both groups decreased,and the scores of Montreal cognitive assessment(MoCA)increased compared with those before treatment(P<0.05);there were no significant differences in NIHSS and MoCA scores between the standard dose group and the low dose group(P>0.05).After 7 days of treatment,the levels of minimal blood flow(Vmin),minimal blood flow(Qmin)and dynamic resistance of cerebral vessels(DR)in both groups increased compared with those before treatment,while the levels of resistance of cerebral vessels(R)and pulse wave velocity(WV)decreased compared with those before treatment(P<0.05);there were no significant differences in the levels of Vmin,Qmin,R,WV and DR between the standard dose group and the low dose group(P>0.05).After 7 days of treatment,the levels of PLT and plateletocrit(PCT)increased compared with those before treatment,while the levels of mean platelet volume(MPV)and platelet volume distribution width(PDW)were decreased in both groups(P<0.05);the levels of PLT,PCT,MPV and PDW in standard dose group and low dose group were no significantly different(P>0.05).After 7 days of treatment,the levels of fibrinogen(FIB)and D-D in the two groups were lower than those before treatment(P<0.05);there were no significant differences in the levels of FIB and D-D between the standard dose group and the low dose group(P>0.05).Conclusion:In the treatment of patients with acute ischemic stroke,both low dose and standard dose of Alteplase can improve nerve function and cognitive function,reduce cerebral circulation resistance,increase cerebral blood flow,improve platelet parameters,and reduce blood hypercoagulability,with similar effects.
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