Impacts of neurointerventional therapy combined with intravenous thrombolysis on neurological function, oxidative stress, and immune function in patients with acute ischemic stroke

神经介入治疗联合静脉溶栓对急性缺血性卒中患者神经功能、氧化应激和免疫功能的影响

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Abstract

AIM: This study aimed to assess the clinical efficacy of neurointerventional therapy plus intravenous thrombolysis in patients with acute ischemic stroke (AIS). METHODS: We conducted a single-center retrospective analysis involving 120 AIS patients admitted to our hospital from January 2023 to December 2024. Based on their treatment plans, patients were categorized into an alteplase group (n = 55) and a combination group (n = 65). In both groups, all patients received standard intravenous thrombolysis with alteplase; in the combination group, this was followed by adjunct neurointerventional therapy, including intra-arterial urokinase infusion and, when indicated, mechanical thrombectomy. We compared neurological function scores, inflammatory factor levels, oxidative stress markers, immune function indicators, hemodynamic parameters, quality of life scores, and the total incidence of adverse reactions between the two groups. RESULTS: After 3 months of treatment, the combination group demonstrated significantly lower NIHSS and mRS scores, as well as reduced levels of IL-6, TNF-α, and hs-CRP, compared to the alteplase group (P < 0.05). Additionally, the combination group exhibited higher SOD levels, lower MDA levels, elevated CD4(+) counts and CD4(+)/CD8(+) ratios, and decreased CD8(+) levels (P < 0.05). Hemodynamically, the combination group had higher minimum cerebral blood flow volume and velocity, along with lower peripheral resistance in cerebral vessels (P < 0.05). Furthermore, the combination group achieved higher GQOLI-74 scores, indicating improved quality of life (P < 0.05). Notably, there was no significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). CONCLUSION: Neurointerventional therapy plus intravenous thrombolysis can improve the neurological function, reduce inflammation and oxidative stress, enhance immune function, improve hemodynamic indicators, improve the quality of life and has good safety in the treatment of patients with AIS.

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