Analysis Of The Factors That Affect The Clinical Outcomes Of Acute Ischemic Stroke Patients Treated With Recombinant Tissue Plasminogen Activator

Objective: To explpre the influencing factors which affect clinical outcome within 90 days after stoke in patients who have received recombinant tissue plasminogen activator therapy.Methods: The clinical data of 64 patients undergoing thrombolysis therapy with acute ischemic stroke treated in the first affiliated hosptial of Soochow University from January 2013 to December 2014 were analyzed retrospectively.The patients’ age,gender,history about hyperlipidemia,hypertension,diabetes mellitus, atrial fibrillation, stroke and other conditions and baseline blood pressure,blood glucose,cholesterol,prothrombin time, and other indicators after admitted to the hospital were collected; the modified Rankin scale(m RS)scores were assessed 90 days after disease onset.We analyzed the relationship between these indexes and clinical score(m RS score).Results: A total of 64 patients were inclueded, including 38 males(59.38%) and 26 females(40.62%). The median of age was 72 years. Sixty patients(93.75%) received intravenous thrombolytic therapy and 4(6.25%) intra-arterially.Favorable outcome was achieved in 54.68 % patients 90 d after thrombolysis with a mortality reaching 6.25%.Univariate analysis showed that poor outcome group had more patients with diabetic history(P=0.002)and presented with higher blood glucose level(P=0.049), higher systolic blood pressure level(P=0.001), higher baseline NIHSS score(P=0.001), longer onset-to-treatment time(P=0.032), more hemorrhagic transformation(P=0.001) and symptomatic intracerebral hemmorrhage(P=0.001) after thrombolysis than favorable outcome group. Logistic regression analysis showed that baseline NIHSS score(OR=1.28,95%CI 1.10-1.49,P=0.001), systolic blood pressure level(OR=1.07,95%CI 1.03-1.12,P=0.022), onset-to-treatment time(OR=1.01,95%CI 1.00-1.03,P=0.048), previous history of diabetes(OR=4.00,95%CI 0.03-0.54,P=0.032)and hemorrhagic transformation(OR=11.00,95%CI 0.004-0.102,P=0.001) and symptomatic intracerebral hemmorrhage(OR=10.00,95%CI 0.01-0.47,P=0.028) after thrombolysis were significantly correlated with prognosis.Conclusion: Baseline NIHSS score, systolic blood pressure level, onset-to-treatment time, previous history of diabetes and hemorrhagic transformation and symptomatic intracerebral hemmorrhage after thrombolysis are independent risk factors of progressing ischemic stroke.