Turgay DÖLEK, Utku CENİLKİ, Vedat Semai BEK, Gülnihal KUTLU

Akut İskemik İnmenin İntravenöz Trombolitik Tedavisinde Muğla Deneyimleri

Akut iskemik inmede ilk 4.5 saat içinde uygulanan rekombinan doku plazminojen aktivatörü etkinliği kanıtlanmış bir tedavi yöntemidir. Bu çalışmada 01.01.2018-01.12.2021 tarihleri arasında trombolitik tedavi uygulanan 71 akut iskemik inme hastasının verilerini analiz etmeyi ve merkezimizin deneyimlerini paylaşmayı amaçladık. Hastaların nörolojik durumları Ulusal Sağlık Enstitüleri İnme Skalası (NIHSS), engellilikleri ise Modifiye Rankin Skalası (mRS) ile değerlendirildi. Trombolitik tedavisinden 24 saat ve 7 gün sonraki NIHSS, geliş NIHSS’ye göre istatistiksel olarak anlamlı düşük saptandı (her ikisi için p<0,001). 3. ay mRS skoru, 24. saat mRS skorundan anlamlı düşüktü (p<0,001). Kapıdan-iğneye veya semptomdan-iğneye zamanı ile rt-PA bitiş NIHSS, 24. saat NIHSS, 7. gün NIHSS, 24. saat mRS ve 3. ay mRS skorları arasında anlamlı ilişki bulunmadı. 24. saat NIHSS, 24. saat mRS ve 7. gün NIHSS ile 3. ay mRS skoru arasında güçlü korelasyon saptandı (sırasıyla r=0.77, 0.907 ve 0.857, p<0.001). rt-PA bitiş NIHSS ile 3 aylık mRS skoru arasında orta düzeyde bir korelasyon vardı (r=0.597, p<0.001). Sonuç olarak trombolitik tedavi prognoza olumlu katkı sunmaktadır. Ayrıca 24. saat ve 7. gündeki klinik durum, 3. aydaki prognozu öngörmede önemlidir ve 3. ay mRS ile NIHSS arasındaki korelasyon zamanla artmaktadır.

Anahtar Kelimeler:

İntravenöz Trombolitik Tedavi, İskemik İnme, mRS, NIHSS

Experiences of Intravenous Thrombolytic Therapy of Mugla in Acute Ischemic Stroke

Recombinant tissue plasminogen activator administered within the first 4.5 hours of acute ischemic stroke is a proven treatment method. In this study, we aimed to analyze the data of 71 patients with acute ischemic stroke who underwent thrombolytic therapy between 01.01.2018 and 01.12.2021 and to share the experience of our center. The neurological status of the patients was evaluated by the National Institutes of Health Stroke Scale (NIHSS) and their disability was evaluated by the Modified Rankin Scale (mRS). NIHSS score at the 24 hours and 7 days after administration of thrombolytic therapy was significantly lower than the initial NIHSS (p<0.001 for both). 3-month mRS score was significantly lower than the mRS score at 24 hours (p<0.001). No significant correlation was found between the door-to-needle time or the symptom-to-needle time and the initial NIHSS, 24-hour NIHSS, 7-day NIHSS, 24-hour mRS and 3-month mRS scores. The 3-month mRS score was strongly correlated with the 24-hour NIHSS, 24 hour-mRS and the 7-day NIHSS (r=0.770, 0.907 and 0.857, respectively, p<0.001). There was a moderate correlation between the NIHSS at the end of the administration of rt-PA and the 3-month mRS score (r=0.597, p<0.001). As a result, thrombolytic therapy positively contributes to the prognosis. In addition, clinical status at 24 hours and 7 days predicts 3-month prognosis and correlation coefficients between NIHSS and the final mRS increase over time.

Keywords:

Intravenous Thrombolytic Therapy, Ischemic Stroke, mRS, NIHSS,

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