Analysis of risk factors for early neurological deterioration in patients with perforating artery atherosclerosis treated by intravenous thrombolysis with ateplase
Objective To explore the risk factors of early neurological deterioration in patients with perforating artery atherosclerosis treated by intravenous thrombolysis with alteplase.Methods A retrospective study was conducted on 639 patients with acute cerebral infarction who were hospitalized in Department of Neurology,Xianyang Central Hospital from January 2021 to January 2023 and received intravenous thrombolysis with ateplase.After intravenous thrombolysis,magnetic resonance diffusion-weighted imaging and angiography were completed,confirming the diagnosis of newly diagnosed cerebral infarction.According to the Chinese ischemic stroke subclassification(CISS)classification criteria,162 patients who met BAD were selected,including 112 males(69.1％)and 50 females(30.9％);they were(63.71±11.44)years old.According to whether the patient experienced early neurological deterioration(END)within 72 hours of intravenous thrombolysis with ateplase,they were divided into an END group(28 cases)and a non-progression group(134 cases).The data were compared between the two groups by independent-sample t test,x2 test,or Fisher's precision probability test,and Mann-Whitney U test.Single factor analysis and multivariate logistic regression analysis were used to identify the risk factors of early neurological deterioration in the patients with perforating artery atherosclerosis treated by intravenous thrombolysis with ateplase.Results The univariate analysis showed that the score of National Institute of Health Stroke Scale(NIHSS)before thrombolysis,moderate to severe stroke(NIHSS score 5-21),systolic blood pressure at admission,door-to-needle time(DNT),and moderate to severe white matter osteoporosis in the END group were higher than those in the non-progression group(all P＜0.05).Further multivariate logistic regression analysis showed that the score of NIHSS before thrombolysis(OR=5.947,95％CI 2.822-46.775,P=0.020)and moderate to severe white matter osteoporosis(OR=3.162,95％CI 1.272-22.357,P=0.034)were risk factors for BAD in the patients.Conclusion NIHSS score before thrombolysis and degree of moderate to severe white matter osteoporosis are risk factors for END in patients with perforating artery atherosclerosis treated by intravenous thrombolysis with alteplase.
万方数据
维普
