A retrospective analysis was carried out for clinical data of 118 patients with
acute ischemic stroke. The patients enrolled were divided into control group (recombinant
tissue plasminogen activator (rt-PA) intravenous thrombolysis) and
thrombectomy group (mechanical
stent interventional
thrombectomy based on rt-PA intravenous thrombolysis). The vascular recanalization rate and clinical efficacy
after treatment were compared between the two groups. National Institutes of Health
Stroke Scale (NIHSS) was used to identify the degree of neurological impairment in all patients before and
after treatment, and Barthel Index was used to assess their activity of daily living. Moreover, the changes in the levels of T-lymphocyte subpopulation in peripheral blood and immuno-inflammatory factors before and
after treatment were compared, and prognosis of patients and incidence of adverse reactions were recorded.
Results: The response rate inthrombectomy group (93.2%) was significantly better than that in control group (76.3%). The NIHSS sore and modified Rankin scale (mRS) score
after treatment were significantly lower than those before treatment, while the Barthel Index
after treatment was distinctly higher than that before treatment. The NIHSS score and mRS score in
thrombectomy group obviously declined compared with those in control group at 1 month
after treatment. The Barthel Index in
thrombectomy group was obviously higher than that in control group at 1 month and 2 months
after treatment. Levels of cluster of differentiation 3 (CD3)+, CD3+CD4+, CD4+/CD8+ and natural killer (NK) cells in peripheral blood at 6 months
after treatment evidently rose compared with those before treatment, while level of CD3+CD8+ evidently declined compared with that before treatment. In
thrombectomy group, levels of CD3+, CD3+CD4+, CD4+/CD8+ and NK cells were markedly higher than those in control group, while the level of CD3+CD8+ was markedly lower than that in control group. Besides, in
thrombectomy group, levels of serum
osteopontin (OPN),
malondialdehyde (MDA) and N-terminal pro-
B-type natriuretic peptide (
NT-proBNP) were evidently lower than those in control group at 1 month
after treatment, while the level of serum
superoxide dismutase (SOD) was evidently higher than that in control group. Compared with that in control group, the acute vascular reocclusion rate in
thrombectomy group was significantly decreased at 3 months
after treatment (10.2% vs. 22.0%).
Conclusions: Intravenous thrombolysis combined with mechanical
stent interventional
thrombectomy can effectively promote the vascular recanalization, improve the neurological function and activity of daily living of patients, reinforce the immunological function, inhibit the oxidative stress response and improve the prognosis of patients.