Effect of Blood Glucose Levels on Thrombolytic Effect of Intravenous Alteplase for Acute Cerebral Infarction

OBJECTIVE To observe the effect of blood glucose levels on thrombolytic effect of intravenous alteplase for acute cerebral infarction. METHODS Eighty-four patients with acute cerebral infarction from January 2013 to December 2013 were collected, according to standard treatment for intravenous alteplase. All patients were marked by score of The National Institutes of Health Stroke Scale (NIHSS). Four points and above of NIHSS reduction 24 h after thrombolysis or symptoms entirely disappearing were defined as void. Random blood glucose before thrombolysis, fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin (HbA1c) after 7 d of thrombolysis, were detected, evaluating their effect on thrombolysis. RESULTS Random blood glucose before thrombolysis, fasting blood glucose, 2 h postprandial blood glucose and HbA1c after 7d admission, were lower in effective group in 24 h after rt-PA thrombolysis, and the fasting glucose after 7 d admission had significant difference (P<0.05). Thrombolysis efficiency gradually decreased with HbA1c values. Thrombolysis efficiency was lower in diabetes group or abnormal glucose tolerance group than normal blood glucose group. Thrombolysis efficiency was better at 7.0-9.0 mmol·L^-1 of random blood glucose before thrombolysis. CONCLUSION Thrombolysis efficiency of alteplase was affected by blood glucose level, higher HbA1c value induced lower efficiency in 24 h after thrombolysis. Controlling random blood glucose before thrombolysis at 7.0-9.0 mmol·L^-1 could highly improve thrombolysis efficiency.