Department of Neurology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Stroke Medicine, North Bristol NHS Trust Southmead Hospital, Bristol, United Kingdom.
Acta Neurobiol Exp (Wars). 2024 Mar 28;84(1):70-79. doi: 10.55782/ane-2024-2540.
Hemorrhagic complications may be seen following reperfusion therapy with rtPA and/or thrombectomy after acute ischemic stroke (AIS). Neutrophils, lymphocytes, and platelets have important roles in the inflammatory and immune responses that develop in these patients. We investigated time‑dependent changes in blood cells, NIHSS and mRS values according to type of reperfusion therapy in AIS patients who developed cerebral hemorrhage. In AIS patients who underwent rtPA and/or thrombectomy and developed cerebral hemorrhage within the first 24 hours after treatment, leukocyte, neutrophil, lymphocyte, platelet counts and their ratios were recorded on admission, 1st, 3rd, and 7th days. NIHSS values on admission, 3rd days and mRS values on admission, discharge, and the 3rd month were recorded. These values were compared according to the type of reperfusion therapy. Out of 436 AIS patients, rtPA was applied in 50.5%, thrombectomy in 28.2%, and rtPA+thrombectomy in 21.3%. Hemorrhage developed in 25.5% of the patients. Patients treated with thrombectomy had a greater rate of cerebral hemorrhage. Pre‑stroke mRS values were lower in all therapy types than mRS scores at discharge and the 3rd month. The NIHSS scores did not differ significantly in 3 days. Depending on the type of reperfusion treatment, there are a few time‑dependent significant changes observed in the blood cell counts and ratios. In conclusion, there is a relation between the type of reperfusion therapy and the time‑dependent changes in blood cells and ratios as well as mRS scores among AIS patients who have undergone rtPA and/or thrombectomy and developed cerebral hemorrhage.
出血并发症可能发生在急性缺血性卒中(AIS)患者接受 rtPA 和/或血栓切除术再灌注治疗后。中性粒细胞、淋巴细胞和血小板在这些患者发生的炎症和免疫反应中具有重要作用。我们研究了发生脑出血的 AIS 患者根据再灌注治疗类型的血细胞、NIHSS 和 mRS 值的时间依赖性变化。在接受 rtPA 和/或血栓切除术且在治疗后 24 小时内发生脑出血的 AIS 患者中,记录入院时、第 1、3 和 7 天的白细胞、中性粒细胞、淋巴细胞、血小板计数及其比值。记录入院时、第 3 天和入院、出院和第 3 个月的 NIHSS 值。根据再灌注治疗类型比较这些值。在 436 名 AIS 患者中,rtPA 应用于 50.5%,血栓切除术应用于 28.2%,rtPA+血栓切除术应用于 21.3%。25.5%的患者发生出血。接受血栓切除术治疗的患者脑出血发生率较高。所有治疗类型的术前 mRS 值均低于出院时和第 3 个月的 mRS 评分。NIHSS 评分在第 3 天没有显著差异。根据再灌注治疗类型,观察到血细胞计数和比值以及 mRS 评分的一些时间依赖性显著变化。总之,接受 rtPA 和/或血栓切除术并发生脑出血的 AIS 患者,再灌注治疗类型与血细胞和比值以及 mRS 评分的时间依赖性变化之间存在一定关系。