Effect of thrombolytic therapy with ateplase on inflammatory cytokines and Hcy levels in patients with acute cerebral ischemic stroke

Abstract

Objective To study the clinical curative effect of thrombolytic therapy with ateplase on acute cerebral ischemic stroke(ACIS) and its effect on serum interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and homocysteine(Hcy) levels. Methods 84 patients with ACIS were selected as observation subjects, and they were divided into observation group and control group according to the random table method, 42 cases in each group.The control group was given conventional treatment of ACIS, and the observation group was given thrombolytic therapy with ateplase on the basis of conventional treatment.The clinical efficacy of the two groups was compared, the National Institutes of Health Stroke Scale(NIHSS) scores, Barthel index changes before treatment and 24h, 14d after treatment, the IL-6, TNF-α and Hcy levels before treatment and 14d after treatment of the two groups were observed and compared. Results The total effective rate of the observation group was 95.24%, which was significantly higher than 78.57% of the control group(χ2=5.126, P<0.05). The NIHSS scores of the observation group 24h and 14d after treatment were (7.41±1.52)points and (5.48±0.93)points, respectively, which were significantly lower than (9.69±2.08)points and (8.07±1.35)points of the control group(t=5.736, 10.239, all P<0.05). The Barthel index scores of observation group 24h and 14d after treatment were (79.48±5.83)points and (86.21±4.33)points, respectively, which were significantly higher than (54.87±5.51)points and (67.22±4.27)points of the control group(t=19.882, 20.237, all P<0.05).14d after treatment, the levels of IL-6, TNF-α and Hcy in the observation group were (7.61±1.39)ng/L, (5.05±0.66)ng/L, (11.19±2.81)μmol/L, respectively, which were significantly lower than (9.29±1.57)ng/L, (8.79±0.93)ng/L, (15.67±2.32)μmol/L in the control group(t=5.192, 21.254, 7.968, all P<0.05). Conclusion The effect of thrombolytic therapy with ateplase for ACIS patients is significant, which can effectively improve the NIHSS and Barthel index scores, and reduce the serum levels of IL-6, TNF-α and Hcy.It is worthy of clinical promotion. Key words: Alteplase; Stroke; Thrombolytic therapy; Chemokines; Homocysteine