关键词: 老年人, 阿替普酶, 急性脑梗死, 静脉溶栓

Abstract: Objective To investigate the clinical efficacy, safety and influencing factors of intravenous thrombolysis with ateplase (rt-PA) in the elderly patients with acute cerebral infarction. Methods A total of 117 patients with acute cerebral infarction with onset time less than 4.5 hours admitted to our hospital from January 2017 to October 2020 were retrospectively analyzed, including 81 males and 36 females. According to age, 83 patients were assigned in control group (＜80 years old) and 34 patients in observation group(≥80 years old). All patients of the two groups were given intravenous thrombolysis with 0.9 mg/kg rt-PA. The acute efficacy [improvement of National Institute of Health stroke scale (NIHSS) score within 14 days], short-term efficacy (Modified Rankin Scale score within 90 days) and safety of rt-PA in the two groups were compared. The influencing factors for the prognosis of intravenous thrombolysis were analyzed by multiple Logistic regression. Results There were no significant differences in curative effect, the incidence rate of complications induced by thrombolysis and mortality after thrombolytic therapy between the two groups (P>0.05). The incidence rate of complications not induced by thrombolysis in observation group was higher than that in control group (20.59% vs 6.02%, P=0.018). Based on multiple Logistic regression analysis, NIHSS score before thrombolysis and complications not inducecd by thrombolysis were independent risk factors for the clinical outcome of intravenous thrombolysis after 90 days. Conclusions Using rt-PA in the thrombolytic time window of the elderly patients with acute cerebral infarction is safe and effective. The score of NIHSS before thrombolysis and complications not induced by thrombolysis shows effects on the prognosis of the patients with acute cerebral infarction aged 80 years old and over.

Key words: aged, ateplase, acute cerebral infarction, intravenous thrombolysis