Analysis Of The Effect Of Urokinase Intravenous Thrombolysis On The Occurrence Of PSD And PSD In The Recovery Period Of Acute Cerebral Infarcti

Objective: by analyzing the effect of urokinase intravenous thrombolysis on the incidence and severity of post-stroke sleep disorder and post-stroke depression,to explore whether thrombolysis is a protective factor of PSSD or PSD,so as to screen the high-risk population of PSSD or PSD more effectively and provide help for its early prevention and treatment.Methods: Patients with acute cerebral infarction within 6 hours of inpatient treatment at the Department of Neurology,Affiliated Hospital of Hebei University from June 2018 to September 2019 were selected as the research subjects.They were divided into thrombolytic group and control group(non-thrombolytic group)according to whether they received intravenous thrombolytic therapy.The cases of lost follow-up and death during follow-up were excluded,and a total of 114 patients were included,including 41 in the thrombolytic group and 73 in the control group.The patients were followed up by telephone and scored by Pittsburgh sleep quality index(PSQI),Hamilton Depression Scale(HAMD)and National Institutes of Health Stroke Scale(NIHSS).One month after the onset of the disease,the neurological deficit and sleep status of the patients were followed up,and NIHSS score and PSQI score were calculated.Three months after the onset of the disease,the neurological deficit and depression related emotional status of the patients were followed up.NIHSS score and HAMD score were calculated.After data collection and sorting,statistical analysis was carried out.The measurement data was expressed by mean ± standard deviation(x ± s).T test was used for comparison between groups.The counting data was expressed by rate and χ 2test was used.Rank sum test was used for rank data.For the independent variables with significant significance in single factor analysis,logistic regression was used for multi factor analysis.Result:1.There was no significant difference in age,gender,hypertension,coronary heart disease,diabetes,smoking,drinking,infarct site of basal ganglia,NIHSS score within 24 hours,PSQI score within 24 hours,HAMD score within 24 hours between the two groups(P > 0.05).2.At the end of 1 month,66 of 114 patients developed PSSD.The incidence of PSSD in the thrombolytic group was 36.59%,the incidence of PSSD in the non-thrombolytic group was69.86%,and the incidence of PSSD in the thrombolytic group was significantly lower than that in the non-thrombolytic group.The univariate analysis results between PSSD group and non-PSSD group showed that: thrombolysis,hypertension,basal ganglia infarction site,NIHSS score at the end of 1 month were related to the occurrence of PSSD,and the differences were statistically significant(P <0.05).Multivariate Logistic regression analysis of the above four variables showed that there was a correlation between thrombolysis,basal ganglia infarction site,NIHSS score at the end of 1 month,and the occurrence of PSSD(P<0.05).3.At the end of 3 months,39 of the 114 patients developed PSD.The incidence of PSD in the thrombolytic group was 19.51%,the incidence of PSD in the non-thrombolytic group was42.47%,and the incidence of PSD in the thrombolytic group was significantly lower than that in the non-thrombolytic group.The univariate analysis results between the PSD group and the non-PSD group showed that: thrombolysis,hypertension,basal ganglia infarction site,NIHSS score at the end of 3 months were related to the occurrence of PSD,and the differences were statistically significant(P <0.05).Multivariate logistic regression analysis of the above four variables showed that there was a correlation between thrombolysis,NIHSS score at the end of 3 months,and the occurrence of PSD.Correlation analysis of the severity of PSD with thrombolysis and NIHSS score at the end of 3 months was used as the variable.The results showed that the effect of NIHSS score at the end of 3 months on the severity of PSD was statistically significant(P <0.05).There was no significant difference in the impact of PSD severity(P> 0.05).Conclusion:1.Thrombolysis is the protective factor of PSSD.The risk of PSSD is lower in patients with thrombolysis after cerebral infarction than in patients without thrombolysis one month later.At the end of one month,NIHSS score and infarction site of basal ganglia were risk factors of PSSD.The higher NIHSS score,the higher risk of PSSD.The risk of PSSD in basal ganglia ishigher than that in non basal ganglia.2.Thrombolysis is the protective factor of PSD.The risk of PSD is lower in patients who have thrombolysis after cerebral infarction than in patients who have not thrombolysis 3months later.At the end of three months,NIHSS score is the risk factor of PSD.The higher NIHSS score is,the higher the risk of PSD is,and the more depression is.