Long-term prognosis and influencing factors of recombinant tissue plasiminogen activator intravenous thrombolysis in patients with acute cerebral infarction
Objective To analyze the long-term prognosis of recombinant tissue plasminogen activator(rt-PA)intrave-nous thrombolysis in patients with acute cerebral infarction(ACI).Methods A retrospective analysis was conducted by select-ing ACI patients admitted to the department of neurology,Beijing Pinggu Hospital from 2019 to 2020(all treated with rt-PA in-travenous thrombolysis).General information of patients was collected,and they were divided into good prognosis group and poor prognosis group based on modified Rankin Scale(mRS)scores after 2 years of follow-up,whether they had recurrent ce-rebral infarction or hemorrhagic transformation.The clinical data of the two groups were compared,and multivariate logistic regression analysis was used to analyze the influencing factors of long-term prognosis of ACI patients.Results Among the 290 ACI patients who were followed up for 2 years,30 patients dropped out,and finally 260 ACI patients completed the follow-up,including 205 patients with good prognosis and 55 patients with poor prognosis(incidence rate of 21.15%).Multivariate Logistic regression analysis showed that old age(OR=1.562,95%CI:1.102 to 2.415),TOAST classification as LAA(OR=1.079,95%CI:1.009 to 1.153),high NIHSS score(OR=2.145,95%CI:1.652 to 2.584)and lack of sustained antiplatelet or anticoagulant therapy(OR=1.895,95%CI:1.336 to 2.475)were independent risk factors for poor long-term prognosis of rt-PA intravenous thrombolysis in patients with ACI.Conclusion The poor prognosis of ACI patients after rt-PA intravenous thrombolysis is still relatively severe 2 years later.For the patients with older age,LAA type,higher NIHSS score,and lack of sustained antiplatelet or anticoagulant therapy,targeted intervention measures should be formulated to improve the long-term prognosis of patients.
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