Observation of clinical efficacy of rt-PA intravenous thrombolytic treatment for patients combined with grade 0-1 diabetic foot by Wagner classification and acute ischemic stroke

摘要

OBJECTIVE: To evaluate the safety and efficacy of rt-PA intravenous thrombolytic treatment for patients with diabetic foot (DF) and acute ischemic stroke. PATIENTS AND METHODS: A retrospective analysis was performed on 76 patients admitted between June 2012 to December 2015 presenting with acute ischemic stroke and Grade 0-1 DF a (Wagner classification). The treatment group consisted of 44 patients who received rt-PA intravenous thrombolytic treatment, while 32 cases in the control group did not. Both groups received monitored dietary therapy and hypoglycemic drugs to control their blood glucose levels. In the treatment group, patients received rt-PA intravenous thrombolytic treatment 4.5h after the onset of ischemic stroke. Physical parameters like color change of sick-foot skin, conditions of ulcer concrescence, changes of skin temperature, and promotion of pain scores were observed in both the groups. RESULTS: The improvement in the rt-PA intravenous thrombolytic treatment group was higher than that in general treatment group, and the difference between them had statistical significance ( p <0.01). Though the improvement of foot symptoms of patients who received rt-PA intravenous thrombolytic was better than that of the control group; there was no obvious statistical difference in the incidence of adverse events between the treatment group and the control group. CONCLUSIONS: rt-PA can reduce the level serum fibrinogen, promotes local microcirculation and nutrition metabolism of diabetic foot, and improve the clinical prognosis of patients with diabetic foot, but will not increase the incidence of adverse events at the same time.