Intravenous thrombolytic therapy with recombinant-tissue plasminogen activator for super early stage of cerebral infarction

Objective To outline ischemic penumbra in hyperacute cerebral infarction with diffusion weighted imaging(DWI),perfusion weighted imaging(PWI) and magnetic resonance imaging(MRI),so as to evaluate the clinical effect and safety of ultra-early intravenous thrombolysis with recombinant-tissue plasminogen activator(rt-PA) in treatment of cerebral infarction.Methods MRI techniques,including DWI,PWI and other MRI technique,were performed in 30 patients with clinically diagnosed hyperacute cerebral infarction.The NIH Stroke Scale(NIHSS) and the blood clotting parameters were compared in 30 patients before and after thrombolysis with intravenous infusion of rt-PA 0.9mg/kg within 6h after onset of cerebral infarction.Mean while,another 30 cases with cerebral infarction treated with routine drugs served as control.Results The NIHSS score declined markedly at 1h after thrombolysis compared with that before thrombolysis(21.0±2.65 vs 25.18±2.98,P0.01),and the NIHSS score decreased significantly at day 30 after thrombolysis compared with that in control group(12.66±4.25 vs 19.12±2.89,P0.01).All the cure rate,effectual rate and total effective rate evaluated 30 days after thrombolysis were higher than those in control group(32.3%,64.2% and 87.4% vs 15.4%,27.5% and 42.8%,respectively.P0.01).Two patients had cerebral hemorrhage complication after thrombolysis,but the outcome was satisfactory.No death occurred in both groups.Conclusion It is revealed that,based on the strict judgment of indications,ultra-early intravenous thrombolysis with 0.9mg/kg of rt-PA in the treatment of cerebral infarction may give a better clinical curative effect with less complication than traditional therapy.