Thrombolysis with alteplase in broadened therapeutic time window for acute cerebral infarction in 37 cases

Objective To evaluate the efficiency and safety of thrombolysis with alteplase for acute cerebral infarction in the broadened therapeutic time window.Methods Ninety-nine patients with acute cerebral infarction were divided into thrombolysis group(n=52)and control group(n=47).According to the different time of thrombolysis,thrombolysis group was redivided into two subgroups,group A receiving thrombolysis in 4.5to 7.0hours after attack and group B receiving thrombolysis in 3to 4.5hours after attack.Both group A and B were treated with alteplase for thrombolysis,and control group was treated with aspirin and drugs for invigorating blood circulation and eliminating stasis.NIHSS scores before,and 1hour,1day,7days and 14 days after treatment,and modified Rankin scale(MRS)scores 90 days after thrombolysis were compared among groups,and the complications were recorded.Results Compared with before treatment,NIHSS decreased one hour after thrombolysis(P0.05)and decreased greatly 14 days after thrombolysis(P0.01)in thrombolysis group,and decreased 7and 14 days after thrombolysis in control group(P0.05).NIHSS scores were lower in thrombolysis group at all time points than those in control group(P0.05).MRS scores 90 days after thrombolysis were 1.5±0.3and 1.7±0.2in group A and B respectively,significantly lower than that in control group(2.5±0.5)(P0.05),and there was no significant difference between group A and B(P0.05).There was no significant difference in the incidence of cerebral hemorrhage between group A(2.7%)and control group(2.1%)(P0.05).Conclusions Thrombolysis with alteplase in the broadened therapeutic time window(4.5to 7.0hours)is safe and effective for acute cerebral infarction.