Analysis Of Factors Affecting Early Prognosis Of Acute Ischemic Stroke Patients With Ultra-Early Intravenous Rt-PA Thrombolysis

Objectives The purpose of this study was to explore the influencing factors of venous thrombolysis and vascular recanalization in the super early stage of cerebral infarction and the effect of vascular recanalization on the recovery of nerve function,so as to summarize the best indications for venous thrombolysis.Methods Patients with acute ischemic stroke who were admitted to the department of neurology of tangshan workers’ hospital from January 2015 to March 2019 and received intravenous thrombolytic therapy with alteplase within 4.5 hours after onset were retrospectively analyzed in this study.The patients were divided into recanalization group(ECR group)and non-recanalization group(n ECR group)according to whether recanalization occurred after thrombolysis(recanalization was defined as the improvement of TICI grade of occlusive responsible vessels after thrombolysis to level 2or above).ECR and n ECR group respectively on the basis of neurological function after thrombolysis again whether to improve(nerve function,defined as the U.S.national institute of stroke scale,NIHSS scores dropped four points OR nerve function fully recovered OR higher)were divided into group and did not pay off group were markedly improved,Collected from the patient’s general information including: age,gender,OTT(the time of onset to treatment: 0-3 hours,3-4.5 hours),the lesion localization(cycle before and after cycle),NIHSS score(all patients before thrombolysis,14 days after thrombolysis NIHSS score),personal history(smoking history and drinking history),past medical history(high blood pressure,diabetes,coronary heart disease,atrial fibrillation,hyperlipidemia,cerebral infarction and cerebral artery stenosis previous medical history)and imaging studies including brain CT and cerebrovascular understand the area of vascular occlusion and lesion location and symptomatic intracranial hemorrhage after thrombolysis.risk factor analysis by using single factor analysis and multiariable Logistic regression model to calculate odds ratio(OR)and 95% confidence interval(95% CI).Results In this study,a total of 175 patients with acute ischemic stroke were treated with alteplase intravenous thrombolysis within 4.5 hours after onset,among which 89 patients achieved complete or partial recanalization of blood vessels after alteplase intravenous thrombolysis,namely ECR group,and 86 patients did not recanalization,namely n ECR group.The neurological function of ECR patients was improved in 40 cases in the immediate group and 49 cases in the non-immediate group.The multivariate Logistic regression analysis showed that: 1)younger age,shorter duration from onset to medication,lower NIHSS score,and significant correlation between small-vessel occlusion and recanalization of blood vessels after intravenous thrombolysis with alteplase(P < 0.05)were independent influencing factors.2)recanalization,short duration from onset to medication,normal blood glucose and no history of alcohol consumption were significantly correlated with early neurological function recovery after intravenous thrombolysis with ateptase(P < 0.05),which were independent influencing factors.Conclusion 1)Patients with younger age,shorter duration from onset to medication,lower NIHSS score and small vessel occlusion are easy to achieve early recanalization after intravenous thrombolysis,which is the indication for recanalization after intravenous thrombolysis.2)Patients with recanalization after thrombolysis,short OTT,normal blood glucose and no history of alcohol consumption are the influencing factor of early better prognosis after intravenous thrombolysis.Figure 1;Table 6;Reference 90...