Observation on the Clinical Efficacy of Intravenous Thrombolysis with Alteplase in Acute Ischemic Stroke across Different Age Groups

Abstract

Objective : Analyzing the differences in clinical efficacy and safety of intravenous thrombolysis with alteplase in patients with acute ischemic stroke across different age groups. Methods : A retrospective analysis was conducted on 319 patients with acute ischemic stroke who received intravenous thrombolysis with alteplase within 4.5 hours of onset. These patients were treated in the Cerebrovascular Disease Department of Zhuhai People’s Hospital between April 2019 and December 2024. Their ages ranged from 29 to 93 years (mean age 66.34 ± 12.79). The patients were divided into five age groups: Group A (29 - 49 years, n = 24), Group B (50 - 59 years, n = 85), Group C (60 - 69 years, n = 78), Group D (70 - 79 years, n = 78), and Group E (>80 years, n = 54). The study compared major risk factors across age groups, NIHSS scores before thrombolysis and at 24 hours and 7 days after thrombolysis, clinical efficacy, modified Rankin Scale (mRS) scores at discharge, and the incidence of post-thrombolysis bleeding events (including intracranial bleeding, oral bleeding, subcutaneous bleeding, and gastrointestinal bleeding) among the different age groups. Results : Statistically significant differences were observed among the five groups in terms of age, BMI, smoking, alcohol consumption, diabetes, hypertension, and the prevalence of atrial fibrillation (P < 0.05). Significant differences were also found in NIHSS scores before thrombolysis, at 24 hours, and at 7 days after thrombolysis (P < 0.05). However, no significant difference was detected in the overall cure rate among the groups (P > 0.05). In contrast, significant differences were observed in the total bleeding rate (P < 0.05) and the mortality rate (P < 0.05). Conclusion : Patients with ischemic stroke across different age groups can benefit from intravenous thrombolysis; however, the risk of post-thrombolysis bleeding and mortality increases with age.