POLTAVA STATE MEDICAL UNIVERSITY, POLTAVA, UKRAINE.
Wiad Lek. 2021;74(6):1307-1311.
The aim: To investigate changes in motor activity and indicators of the state of the hemostasis system in the acute period of ischemic stroke during systemic thrombolytic therapy and without its use.
Materials and methods: We examined 26 male and female patients with a clinical diagnosis of ischemic stroke, who were hospitalized on the first day of the disease to the neurological departments. Patients were divided into 2 groups: group 1-patients who underwent systemic thrombolytic therapy (sTLT) (n=11), group 2-patients who did not receive sTLT (n=15). To compare the coagulogram parameters, 12 healthy patients were examined (control group). Examination of patients was performed on the 1st and 14th day of the disease (clinical examination, assessment of motor activity, coagulation test). Stroke severity was determined by the overall score of the National Institutes of Health Stroke Scale.
Results: The average age of patients in group 1 - 60.1±8.2 years old, in group 2 -61.3±5.5 years old. The number of points on the NIHSS scale in group 1 was 8.8±1.13 on 1st day and 3.7±0.79 on 14th day (p<0.05), in group 2 -5.7±0,94 on the 1st day and 3.1±0.93 on the 14th day(p<0.05). The results of the study of the coagulogram indicate a significantly higher level of soluble fibrin-monomer complexes on the 1st day on the 14th day of the ischemic stroke.
Conclusions: In the acute period of ischemic stroke changes in the hemostasis system reflected the direction of the selected therapy. The use of systematic thrombolytic therapy in ischemic stroke led to a more severe decrease in stroke severity on the NIHSS scale, a significant increase in Barthel index.
研究急性缺血性脑卒中患者在接受和不接受系统性溶栓治疗期间运动活动和止血系统状态指标的变化。
我们检查了 26 名男性和女性患者,他们的临床诊断为缺血性脑卒中,在疾病的第一天被送往神经科病房。患者被分为 2 组:组 1-接受系统性溶栓治疗(sTLT)的患者(n=11),组 2-未接受 sTLT 的患者(n=15)。为了比较凝血谱参数,我们检查了 12 名健康患者(对照组)。在疾病的第 1 天和第 14 天对患者进行检查(临床检查、运动活动评估、凝血试验)。脑卒中严重程度由国立卫生研究院脑卒中量表的总分确定。
组 1 的平均年龄为 60.1±8.2 岁,组 2 为 61.3±5.5 岁。组 1 的 NIHSS 量表评分第 1 天为 8.8±1.13,第 14 天为 3.7±0.79(p<0.05),组 2 第 1 天为 5.7±0.94,第 14 天为 3.1±0.93(p<0.05)。凝血谱研究结果表明,在缺血性脑卒中的第 14 天,可溶性纤维蛋白单体复合物的水平明显升高。
在急性缺血性脑卒中期间,止血系统的变化反映了所选择治疗的方向。在缺血性脑卒中中使用系统性溶栓治疗导致 NIHSS 评分上脑卒中严重程度显著降低,Barthel 指数显著增加。