Abstract:
Measures to expedite clot lysis and restore circulation may limit the extent of brain injury and
improve outcome after stroke. Unfortunately, intracranial bleeding was frequent among persons
enrolled in studies performed in the late 1960s and 1970s, and the therapy was abandoned. More
recently, interest in thrombolytic therapy revived because of development of new drugs and their
successful use in the care of persons with myocardial ischemia. In addition, a meta-analysis combining data from several pilot studies in stroke suggested that thrombolytic therapy might be
useful. Available thrombolytic drugs are recombinant tissue plasminogen activator (r-TPA),
streptokinase, p-anisoylated lys-plasminogen-streptokinase activator complex, urokinase, and
prourokinase. A number of pilot studies evaluated the potential safety and efficacy of early
administration of thrombolytic drugs using both intravenous and intra-arterial approaches.
Investigators reported generally positive results and an acceptable degree of safety. To study
efficiency of preparation Actilyse® (rt-PA) at patients in different terms of treatment and
rehabilitation. In the research program with acute ischemic stroke 12 patients have been included
(according to criteria of inclusion in groups of treatment NINDS - Trial). To all patients during 3 h
have been made CT, transcranial doppler investigation for localisation specification of occlusion and
time of recanalisation. Middle age of patients is 61,3 +/-9,6 years. Neurologic deficiency estimated on
scale NYHS, in research also used Bartel Index and Rankin Index. Dose Actilyse® (rt-PA) - 0,9
mg/kg. Results. Average term of hospitalisation 10,5 +/-3,4 day. NYHS Bartel Index Rankin Index 1
day 16+/-3.5 13,3+/-8,7 4,3+/-0,6 7 day 9,5+/-5,4 57,2+/-28,4 2,8+/-1,6 30 day 7,2+/-5,3 70,5+/-25,6
2,4+/-1,2 6 months 6,5+/-4,l 80,4+/-19,2 l,5+/-0,9. Thrombolytic therapy with Actilyse® (rt-PA) is
very effective and is one of the newest methods for treatment of patients with acute ischemic stroke in
Moldova. We recommend this method to use also in other centres on treatment of strokes at us in the
country.
