Safety of different doses of alteplase for intravenous thrombolysis in patients with acute cerebral infarction

Abstract

Objective To compare the safety of different doses of alteplase for intravenous thrombolysis in patients with acute cerebral infarction to provide a basis for clinical rational use of this drug. Methods A total of 283 acute cerebral infarction patients were randomly divided into a low dose group (n=140) and a standard dose group (n=143). The medical records of all patients were collected, and the prognosis of patients was evaluated with the modified Rankin scale (mRS), with an mRS score of 0-2 indicating a good prognosis. The chi-square test or Mann-Whitney U test was used to compare the clinical efficacy and mortality of the two groups, and to evaluate the safety of different doses of alteplase for intravenous thrombolysis in patients with acute cerebral infarction. Results At 24 h and 3 days after thrombolysis, there was no significant difference in the National Institute of Health stroke scale (NIHSS) between the two groups [6 (2, 12) vs 5 (2, 10), Z=0.361, P=0.718; 4 (2, 11) vs 4 (2, 10), Z=0.118, P=0.906]. At 7, 28, and 90 d after thrombolysis, there was no significant difference in the proportion of patients with a good prognosis between the two groups (52.86% vs 53.85%, χ2=0.002, P=0.962; 64.29% vs 62.94%, χ2=0.013, P=0.911; 70.00% vs 72.03%, χ2=0.06, P=0.807). There was no significant difference in the rate of hemorrhagic transformation between the two groups after thrombolysis (6.43% vs 7.69%, χ2=0.040, P=0.842). By 90 days after thrombolysis, 11 patients in the low dose group and 12 patients in the standard dose group died, and there was no significant difference in mortality between the two groups (χ2=0.120, P=0.73). Conclusion Different doses of alteplase for intravenous thrombolysis in patients with acute cerebral infarction have similar safety and efficacy, and low doses of alteplase for intravenous thrombolysis is worthy of clinical application. Key words: Acute cerebral infarction; Alteplase; Intravenous thrombolysis