Clinical Application of Intravenous Thrombolysis in Transient Ischemic Attack and Ischemic Stroke Guided by Multimodal MRI

摘要

Objective: To investigate the therapeutic effect of intravenous thrombolysis on TIA (Transient Ischemic Attack) under the guidance of multimodal MRI (magnetic resonance imaging), and the clinical application of intravenous thrombolysis in patients with ischemic stroke. Methods: Patients with acute ischemic stroke who underwent intravenous thrombolysis in the Department of Neurology from December 2017 to December 2018 were selected. Through CT (computed tomography) screening, 146 patients that met the diagnostic criteria were eventually included. Patients were randomly divided into group A (72 patients) and group B (74 patients). Patients in group A received antiplatelet therapy within 24 h after intravenous thrombolytic therapy for 10 days. The platelet therapy was discontinued when symptomatic intracerebral hemorrhage (SICH) occurred or NIHSS score was >= 4. In group B, after intravenous thrombolysis and antiplatelet therapy, multimodal MRI was used to detect the presence of hemorrhage and other conditions to determine whether to continue the antiplatelet therapy. The NIHSS scores before and after thrombolysis and the 90-day mRS scores after thrombolysis were collected for statistical analysis. Results: The experimental results of each group of patients showed that there was a significant difference in NIHSS scores at admission and 6 h after thrombolysis (P < 0.05). The 30-day mRS score, 90-day mRS score, and prognosis were statistically significant in both groups. The differences in NIHSS scores at 6 h, 24 h, 7 d, and 14 d after thrombolysis and at admission were 1, 1.6, 1.8, and 2.8, which were statistically significant. A comparison of the prognosis of the two groups of patients with hemorrhage 24 h after thrombolysis revealed that the hemorrhage of each patient was improved. Conclusion: In the treatment of ischemic stroke diseases, the utilization of multimodal MRI in clinical intravenous thrombolytic therapy was valuable, which was very sensitive to the detection and display of blood focus. Also, in the selection of treatment methods for clinical thrombolysis in stroke patients, the targeted treatment could be better individualized for each patient.