Dependence of the effectiveness of thrombolytic therapy at ischemic stroke from clinical and paraclinical predictors

Authors

  • Іванна Михайлівна Мельнічек Lviv National Medical University 69 Pekarska str., Lviv, Ukraine, 79010, Ukraine
  • Анжеліка Володимирівна Паєнок Lviv National Medical University 69 Pekarska str., Lviv, Ukraine, 79010, Ukraine
  • Галина Михайлівна Пришляк Municipal clinical hospital of emergency medical service 9 Mykolajchuka str., Lviv, Ukraine, 79059, Ukraine

DOI:

https://doi.org/10.15587/2313-8416.2015.56428

Keywords:

Actilyse, alteplase, thrombolytic therapy, brain infraction, inshemic stroke, predictors of effectiveness

Abstract

The aim of the work. The aim of the work is an assessment of informativeness of several clinical and paraclinical predictors in prognostics of the results of effectiveness of thrombolytic therapy at the most acute period of ishemic stroke with the further definition of the most significant ones for achieving the least neurologic deficiency.

Methods of research: There were retrospectively considered 61 patients 60,5±7,8 years old with ishemic stroket who sucsessfully underwent thrombolytic therapy as an intravenous administration of Actilyse. These patients demonstrated the next factors of gemostasis: prothrombin time, prothrombin index, fibrinogen. For the research there were also used the scales of neurological deficiency activisation (Rankin and NIHSS); ultrasound of the magistral arteries and extracranial CT of brain; methods of mathematical statistics (the definition of chances and confidence intervals ratio, Pirson and Student criteria, verification of hypothesis about the law of distribution and equality of the mean values in the both samplings.

Results. There were defined the most informative factors in prognostication of the good result after thrombolytic therapy. There was formed the list of output factors that the results of actilyse thrombolytic therapy effectiveness in Lviv region are depending on. There was grounded the necessity of laboratory data monitoring in patients with stroke for receiving the best results of thrombolytic therapy.

There was established that thrombolytic therapy of ishemic stroke must begin as early as possible (in computed tomography department if possible) for receiving the maximal effectiveness. There was detected that ultrasound of magistral vessels that supply brain with blood is necessary for all patients who are candidates for thrombolytic therapy because the stenosis of the vessel lumen more than 60 % significantly worsens an effectiveness of treatment

Author Biographies

Іванна Михайлівна Мельнічек, Lviv National Medical University 69 Pekarska str., Lviv, Ukraine, 79010

Department of Neurology and Neurosurgery

Анжеліка Володимирівна Паєнок, Lviv National Medical University 69 Pekarska str., Lviv, Ukraine, 79010

Doctor of Medical Sciences, Professor

Head of the Department of Neurology and Neurosurgery

Галина Михайлівна Пришляк, Municipal clinical hospital of emergency medical service 9 Mykolajchuka str., Lviv, Ukraine, 79059

Chief of Department of Neurology № 2

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Published

2015-12-29

Issue

Section

Medical