Exploring the factors leading to brain herniation in patients with acute cerebral infarction after intravenous thrombolysis therapy
Objective To explore the risk factors of brain herniation in patients with acute cerebral infarction after intravenous thrombolysis therapy based on propensity score matching(PSM)method.Methods A retrospective selection was conducted on 443 patients with acute cerebral infarction who underwent intravenous thrombolysis treatment in our hospital from January 2019 to May 2023.They were divided into brain herniation group and non brain herniation group based on the presence or absence of brain herniation after intravenous thrombolysis treatment.The baseline data of the two groups were balanced using PSM method,and the risk factors for cerebral hernia formation after intravenous thrombolysis treatment in patients with acute cerebral infarction after PSM were analyzed using univariate and multivariate Logistic regression analysis.Results After PSM,a total of 57 pairs of patients were successfully matched between the brain herniation group and the non brain herniation group.There was no statistically significant difference in gender,age,smoking history,and drinking history between the two groups(all P＞0.05).The results of univariate analysis showed that there were statistically significant differences between the brain herniation group and the non brain herniation group with atrial fibrillation,TOAST typing,infarction site,massive cerebral infarction,NIHSS score,platelet count,neutrophil count/lymphocyte count(NLR),D-dimer,C-reactive protein,successful recanalization of blood vessels,and poor collateral circulation(all P＜0.05).The results of multivariate Logistic regression analysis showed that TOAST classification was cardiogenic embolism type,anterior circulation infarction,massive cerebral infarction,poor collateral circulation,high NIHSS score,and high NLR were all independent risk factors for brain herniation in patients with acute cerebral infarction after intravenous thrombolysis treatment(all P＜0.05).Conclusion After balancing gender,age,smoking history and drinking history using PSM,cardiogenic embolism type in TOAST classification,anterior circulation infarction,massive cerebral infarction,poor collateral circulation,high NIHSS score,and high NLR are all independent risk factors for the formation of brain herniation in patients with acute cerebral infarction after intravenous thrombolysis treatment.
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