The study on dose-effect, time-effect and safety of alteplase in the treatment of acute cerebral infarction

Objective To explore the dose-effect, time-effect and safety of alteplase in the treatment of acute cerebral infarction. Methods One hundred and ten patients with acute cerebral infarction were selected, among whom 50 patients whose time window ≤3.0 h were divided into group A and group B by random digits table method with 25 cases each, and 60 patients whose time window 3.1-4.5 h were divided into group C and group D by random digits table method with 30 cases each. The patients in group A and group C received alteplase 0.6 mg/kg (maximum dose 60 mg) intravenous thrombolysis; the patients in group B and group D received alteplase 0.9 mg/kg (maximum dose 90 mg) intravenous thrombolysis. The national institutes of health stroke scale (NIHSS) scores before treatment and 1 h, 24 h, 7 d, 30 d and 90 d after treatment were observed in the 4 groups. The therapeutic effect, complication incidence and fatality rate were compared. The prognosis was estimated by modified Rankin scale (mRS) score 90 d after treatment. Results The NIHSS scores 1 h, 24 h, 7 d, 30 d and 90 d after treatment were significantly lower than those before treatment in the 4 groups, and there were statistical differences (P 0.05). The rate of eusemia in group A was 76.00% (19/25), in group B was 64.00% (16/25), in group C was 43.33% (13/30), and in group D was 53.33% (16/30). And there were no statistical differences between group A and group B (χ2=0.620, P>0.05), and between group C and group D (χ2=0.069, P>0.05). Conclusions The low dose alteplase is also effective and safe to acute cerebral infarction patients at time window ≤ 3 h. It is also effective and safe to acute cerebral infarction patients at time window 3.0-4.5 h at standard dose. Key words: Tissue plasminogen activater; Brain infarction; Dose-effect; Time-effect; Safety