Clinical observation of Alteplase in treatment of senile patients with acute cerebral infarction

Objective To evaluate the clinical efficacy and safety of thrombolysis with intravenous recombinant tissue plasminogen activator(rt-PA, Alteplase) for senile patients with acute cerebral infarction. Methods From June 2011 to June 2013, 80 elderly patients diagnosed with acute cerebral infarction in Tianjin First Central Hospital were randomly devided into treatment group(40 cases) and control group(40 cases). Patients in the treatment group received rt-PA at 0.9 mg/kg dosage, 10% of total dose was iv injected and the remaining was iv dripped within the following 60 min. Cranial CT was performed to determine the status of bleeding in patients 24 h later. The patients in the control group were po administered with bayaspirin, once daily. Two groups were treated for 7 d. The scores of European Stroke Scale(ESS) and Barthel Index(BI) before and after the treatment at days 1, 3, 7, 30, and 90 were compared. Results The neurological function of patients was significantly increased in both two groups after treatment. The scores on the ESS were significantly increased in both two groups after treatment at days 3, 7, 30, and 90(P0.05); After the treatment, ESS scores in the treatment group showed a more obvious increase compared to the control group(P0.05). Barthel index significantly increased in both two groups after the treatment(P0.05). There was no significant statistical difference in the two groups after the treatment for 1 d. But Barthel index showed a significant increase after the treatment for 3, 7, 30, and 90 d in the treatment group compared to the control group(P0.05).Conclusions The treatment of senile patients with acute cerebral infarction using rt-PA could significantly improve the neurological deficits and improve the activities of daily living.