阿替普酶静脉溶栓前应用依达拉奉对老年急性脑梗死预后的影响

目的 探讨老年急性脑梗死病人在应用阿替普酶(recombinant tissue plasminogen activator,rt-PA)静脉溶栓前预先使用依达拉奉的有效性和安全性.方法 采用回顾性分析的方法,纳入2014～2018年南京医科大学第二附属医院脑卒中登记系统中接受rt-PA静脉溶栓及依达拉奉联合治疗的老年...

Effects of edaravone on outcomes in the elderly patients with acute ischemic stroke treated with recombinant tissue plasminogen activator

Objective To investigate the effect edaravone before or after recombinant tissue plasminogen activator(rt-PA)on the outcome of acute ischemic stroke in the elderly patients.Methods A retrospective cohort study was conducted using the stroke register database in the Second Affiliated Hospital of Nanjing Medical University.A total of 135 elderly patients with ischemic stroke from 2014 to 2018 were selected.The patients received edaravone before rt-PA administration were enrolled as study group(n=67),and those who received edaravone after rt-PA were enrolled as control group(n=68).The scores of modified Rankin Scale(mRS)90 d after treatment,National Institutes of Health Stroke Scale(NIHSS)scores 24 h and 7 days after intravenous thrombolysis,the incidence rate of acute cerebral infarction hemorrhagic transformation,7-day and 90-day mortality were compared between the two groups.Results The NIHSS scores 24 h and 7 days after intravenous thrombolysis were lower in study group than those in control group(8.67±8.55 vs 11.88±8.30;5.08±5.35 vs 8.60±7.91),90 d recanalization rate was higher in study group than that in the control group(53.73%vs.27.94%).The rates of intracranial hemorrhage(ICH)(9.1%vs.18.3%)and the rate of symptomatic intracranial hemorrhage(sICH)(2.0%vs.8.7%)in study group were lower than those in control group.Logistic regression analysis showed that the administration of edaravone before rt-PA was significantly associated with lower mRS scores of the patients(OR=0.28,95%CI 0.14-0.58).Conclusions The administration of edaravone before rt-PA may improve the outcome in the elderly patients with acute ischemic stroke treated with rt-PA.