Clinical observation of different reperfusion methods in patients with acute ischemic stroke with atrial fibrillation within 4.5 hours from onset
Journal
Zhonghua yi xue za zhi
Journal Volume
99
Journal Issue
44
Pages
3477-3480
Date Issued
2019
Author(s)
Abstract
Objective: To detect the ideal treatment for acute ischemic stroke (AIS) patients with atrial fibrillation (AF) within 4.5 hours from onset. Methods: A total of 95 AIS patients with AF was retrospectively analyzed from April 2014 to January 2019. Thirty patients (group A) were treated with endovascular treatment directly, 35 (group B) patients were treated with intravenous recombinant tissue plasminogen activator (rtPA) followed by endovascular treatment, and 30 (group C) patients were treated with intravenous rtPA only. There were no significant differences among the groups in baseline data as age, gender, underlying diseases, medication, National Institutes of Health Stroke Scale (NIHSS) score, time from onset to treatment. Modified thrombolysis in cerebral infarction (mTICI), Symptomatic hemorrhagic transformation (SICH), 90 d prognosis of modified Rankin Scale (mRS) and death were compared. Results: Recanalization (mTICI≥2b) was similar in group A and B (70.0% vs. 68.6%, P>0.05). SICH of group A (6.7%) was significantly lower than that of group B (31.4%, P0.05). Prognosis (mRS≤2) was significantly better in group A (70.0%) than that in group B (37.1%) and group C (30.0%), both P0.05. Conclusion: AIS patients with AF within 4.5 hours from onset should receive endovascular treatment directly. 目的： 探讨不同再灌注方法对发病4.5 h内伴房颤（AF）的急性缺血性脑卒中（AIS）患者疗效情况。 方法： 回顾性分析2014年4月至2019年1月南通市通州区人民医院卒中中心收治的伴AF的AIS患者，分别采用直接血管内治疗（A组，30例）、阿替普酶静脉溶栓联合血管内治疗（B组，35例）和单纯静脉溶栓治疗（C组，30例），各组年龄、性别、基础疾病、发病前用药、入院时美国国立卫生研究院卒中量表评分（NIHSS）、发病到开始治疗时间等基线资料差异无统计学意义，比较治疗后脑梗死溶栓分级（mTICI）、症状性出血转化（SICH）、90 d改良Rankin量表评分（mRS）及死亡。 结果： A组脑再灌注良好（mTICI≥Ⅱb，70.0%）与B组相似（68.6%），P>0.05；A组SICH（6.7%）明显少于B组（31.4%，P0.05）；A组90 d良好预后（mRS≤2，70.0%）显著高于B组（37.1%）和C组（30.0%），均P0.05）。 结论： 发病4.5h内伴AF的AIS患者适用直接血管内治疗。.
SDGs
Publisher
NLM (Medline)
Type
journal article