To evaluate the effect of alteplase combined with butylphthalide on early neurological deterioration after intravenous thrombolysis in acute ischemic stroke.

A retrospective analysis was performed on 171 patients with acute ischemic stroke undergoing intravenous thrombolysis at the Third People’s Hospital of Hubei Province from August 2017 to January 2020, including 29 patients in the treatment group (alteplase plus butylphthalide) and 142 patients in the control group (alteplase only). Propensity score matching was used to analyze and balance the clinical baseline data of patients in the two groups. The incidence of early neurological deterioration (NIHSS score ≥4 points higher than before) within 72 h in the 2 groups was compared.

There was no statistical difference in age, gender, NIHSS score, hypertension, diabetes, atrial fibrillation, coronary heart disease, hyperlipidemia, cerebral infarction, modified Rankin scale score, systolic pressure, diastolic blood pressure, onset to intravenous thrombolysis time, TOAST classification, antiplatelet or anticoagulant drugs, and statins drugs between the two groups (P＞0.05). Blood glucose [(8.54±4.03) mmol/L vs (7.32±2.03) mmol/L, t=2.407, P=0.018)], door to intravenous thrombolysis time [36(25, 45) min vs 27(18, 43) min, Z=-2.189, P=0.029)] and the incidence of early neurological deterioration within 72 hours (31.0% vs 10.3%, χ²=5.148, P=0.023) in the treatment group were lower than those in the control group. Twenty-three pairs were matched successfully by the propensity score matching, that is, 23 patients in the treatment group and 23 in the control group. The incidence of early neurological deterioration in the treatment group was still lower than that in the control group (8.7% vs 34.8%, χ²=4.60, P=0.032).

The incidence of early neurological deterioration after intravenous thrombolysis of alteplase plus butylphthalide group was lower than that of the alteplase group.