IMPROVEMENT OF NEUROLOGICAL FUNCTION, HEMODYNAMICS, AND ACTIVITIES OF DAILY LIVING IN PATIENTS WITH ISCHEMIC STROKE TREATED WITH TENECTEPLASE INTRAVENOUS THROMBOLYSIS

This study assessed the effects of tenecteplase (rh-TNK-TPA) in ischemic stroke treatment, focusing on neurological function, cerebral blood flow, inflammation, and quality of life.Fifty-three patients received rh-TNK-TPA and 47 received alteplase.The rh-TNK-TPA formulation showed a single-chain content of 73.47% and molecular weight of 58,778.23 Da.Baseline data were comparable between groups (p > 0.05).Clinical efficacy was significantly higher in the rh -TNK-TPA group (96.23%) than in the alteplase group (87.23%) (p < 0.05).Neurological biomarkers (NSE, UCH-L1, MBP, GFAP, S-100) decreased in both groups post-treatment, with more significant reductions in the experimental group.Cerebral blood flow improved, with increased MCA values and decreased ACA/PCA values, more favourable in the rh-TNK-TPA group (p < 0.05).Inflammatory markers, TLR-4, and NF-B levels declined after treatment, significantly more in the rh-TNK-TPA group (p < 0.05).Quality of life improved in both groups, but more markedly in the experimen tal group (p < 0.05).Adverse reactions and mortality showed no significant differences (p > 0.05).Overall, rh-TNK-TPA thrombolysis improves clinical outcomes and quality of life by reducing inflammation and neurological injury via TLR-4/NF-B pathway modulation, supporting its clinical use. RezumatAcest studiu a evaluat efectele tenecteplazei (rh-TNK-TPA) n tratamentul accidentului vascular cerebral ischemic.Cinzeci i trei de pacieni au primit rh-TNK-TPA, iar 47 au fost tratai cu alteplaz.Eficiena clinic a fost semnificativ mai mare n grupul rh-TNK-TPA (96,23%) comparativ cu grupul alteplaz (87,23%) (p < 0,05).Biomarkerii neurologici (NSE, UCH-L1, MBP, GFAP, S-100) au sczut n ambele grupuri dup tratament, cu reduceri semnificativ mai pronunate n grupul experimental.Fluxul sanguin cerebral s-a mbuntit, valorile pentru artera cerebral median (MCA) au crescut, iar cele pentru arterele cerebral anterioar i posterioar (ACA/PCA) au sczut.Nivelurile markerilor inflamatori, precum i expresia TLR-4 i NF-B, au sczut dup tratament, n mod semnificativ mai accentuat n grupul rh -TNK-TPA.Calitatea vieii s-a mbuntit n ambele grupuri, dar mai vizibil n grupul experimental (p < 0,05).Nu s-au nregistrat diferene semnificative ntre grupuri n ceea ce privete reaciile adverse i mortalitatea (p > 0,05).