| Objective: To observe the CT imaging features of the head in patients with hyperacute anterior circulation cerebral infarction,and to analyze the correlation between the CT imaging signs of the head and the outcome of intravenous thrombolysis with recombinant tissue-plasminogen activator(rt PA).Methods: 120 patients with hyperacute anterior circulation ischemic stroke received in our hospital from January 2017 to June 2018 were selected for clinical exploration.According to the modified Rankin scale score(m RS)of 3 months,the patients were divided into good prognosis group(m RS≤2)and bad prognosis group(m RS>2).Among them,72 patients had good prognosis and 48 patients had poor prognosis.The data of all patients were retrospectively analyzed to collect demographic,clinical and imaging features of patients.rt PA intravenous thrombolysis was administered to all patients.The imaging data of all patients were collected.All patients were examined by CT before intravenous thrombolysis.SPSS20.0 statistical software was used to process the statistical data,P<0.05 indicated that the difference had statistical significance.Single factor analysis was used to compare the variables in the two groups,and the variables(P<0.05)were included in the multivariate logistic regression analysis.Results:(1)There was no statistical significance in sex,hypertension,hyperlipidemia,diabetes,pre-thrombolytic diastolic blood pressure,pre-stroke m RS score between the group with good prognosis and the group with poor prognosis(P>0.05).Age,transient ischemic attack and atrial fibrillation,pre-thrombolytic blood sugar,pre-thrombolytic systolic blood pressure,and thrombolytic time between the two groups were not significant(P>0.05).The former NIHSS scores were significantly different(P<0.05),which confirmed that the above factors were a possible single predictive factor of poor prognosis.(2)10% of the patients were diagnosed by head CT images and were initially assessed as completely normal,i.e.without early ischemic changes and existing signs;80.83% of the patients were diagnosed as abnormal but without early ischemic changes;9.17% of the patients were diagnosed as early ischemic changes.(3)There was no significant correlation between severe brain tissue low density,brain tissue swelling and the good outcome of intravenous thrombolysis for 3 months(P> 0.05);the early signs of ischemia such as infarction,low density and high density of middle cerebral artery are significantly related to the good outcome of intravenous thrombolysis for 3 months(P<0.05).There was no significant correlation between the existing signs(leukoaraiosis of brain,cerebral atrophy,old cerebral infarction,calcification of intracranial artery)and the good outcome of 3 months after intravenous thrombolysis(P>0.05).(4)There was no significant correlation between imaging features and SICH in prognosis of intravenous thrombolysis(P>0.05).(5)Age,transient ischemic attack,atrial fibrillation,hyperglycemia,higher systolic pressure,and high NIHSS score before thrombolysis were independent predictive factors for poor prognosis of intravenous thrombolysis(P<0.05).Conclusion: There are many factors affecting the prognosis of intravenous thrombolysis with rt PA,and the early ischemic signs of the brain CT imaging are closely related to the outcome of intravenous thrombolysis.The low density of the tissue,high density of the MCA in the CT imaging signs of the head are closely related to the adverse outcome of intravenous thrombolysis 3 months later.There was no significant correlation between CT findings and 48 hour SICH after intravenous thrombolysis.Age,transient ischemic attack,atrial fibrillation,hyperglycemia,higher systolic pressure,high NIHSS score before thrombolysis and early signs of ischemia were independent predictive factors for poor prognosis of intravenous thrombolysis. |
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