The impact of shortening DNT on the prognosis of acute cerebral infarction patients undergoing intravenous thrombolysis
缩短DNT时间对急性脑梗死静脉溶栓患者预后的影响

摘要

目的 分析缩短急性脑梗死静脉溶栓患者入院至静脉溶栓治疗时间（DNT）对预后情况的影响作用。方法 将我院2023年1月-2024年6月急性脑梗死发病6小时以内开展静脉溶栓的374例患者纳入研究，根据DNT时间将患者分为两组，分别命名为对照组（DNT＞60 min，50例）与实验组（DNT≤60 min，324例），对两组患者的神经功能、氧化应激与预后情况进行评估并比较。结果 两组患者在溶栓前至溶栓后24 h、14 d的美国国立卫生院神经功能缺损表（NIHSS）评分均呈现明显下降趋势，且在溶栓后24 h、14 d实验组NIHSS评分较低（P<0.05）；实验组患者溶栓后90 d 改良Rankin量表（MRS）评分总体水平低于对照组（P<0.05）；与溶栓前比较，在溶栓后两组患者超氧化物歧化酶（SOD）水平升高，丙二醛（MDA）水平降低，且实验组患者SOD水平高于对照组，MDA水平低于对照组（P<0.05）；死亡率、出现致死性脑出血率在两组患者中比较，实验组明显较低（P<0.05）。结论 说明DNT时间越短，急性脑梗死患者预后情况越好，且缩短DNT时间有利于改善患者神经功能与氧化应激指标。

Abstract

Objective To analyze the impact of shortening the door-to-needle time (DNT) on the prognosis of patients with acute cerebral infarction undergoing intravenous thrombolysis.
Methods A total of 374 patients with acute cerebral infarction who received intravenous thrombolysis within 6 hours of onset from January 2023 to June 2024 in our hospital were included in the study. Patients were divided into two groups based on DNT: the control group (DNT > 60 min, 50 patients) and the experimental group (DNT ≤ 60 min, 324 patients). The neurological function, oxidative stress, and prognosis of the two groups were assessed and compared.
Results The National Institutes of Health Stroke Scale (NIHSS) scores of both groups showed a significant decrease from before thrombolysis to 24 hours and 14 days after thrombolysis, with the experimental group having lower NIHSS scores at 24 hours and 14 days after thrombolysis (P < 0.05). There was no significant difference in the level of oxidative stress indicators between the two groups before thrombolysis (P > 0.05). The overall level of the modified Rankin Scale (MRS) score at 90 days after thrombolysis was lower in the experimental group than in the control group (P < 0.05). Compared with before thrombolysis, the levels of superoxide dismutase (SOD) increased and malondialdehyde (MDA) decreased in both groups after thrombolysis, with the experimental group having higher SOD levels and lower MDA levels than the control group (P < 0.05). The mortality rate and the rate of fatal cerebral hemorrhage were significantly lower in the experimental group compared to the control group (P < 0.05).
Conclusion   These findings indicate that the shorter the DNT, the better the prognosis of patients with acute cerebral infarction, and shortening the DNT is beneficial for improving neurological function and oxidative stress indicators in patients.