Analysis of the effect of reperfusion after intravenous thrombolysis in different time windows of acute ischemic stroke on clinical outcome and 90-day prognosis
Analysis of the effect of reperfusion after intravenous thrombolysis in different time windows of acute ischemic stroke on clinical outcome and 90-day prognosis
Objective To analyze the effect of reperfusion after thrombolysis in different time windows on clinical outcome and 90-day prognosis of acute ischemic stroke(AIS).Methods A total of 158 AIS patients who received intravenous thrombolytic therapy in the Department of Neurology of the Northern Ward of the Third People's Hospital of Zhengzhou from October 2020 to October 2022 wereselected.The patients were divided into three groups according to the thrombolytic time window:A(42 cases),B(53 cases)and C(63 cases).The thrombolytic time windows were＜3.0 h,3.0-4.5 h,and＞4.5-＜6.0 h,respectively.The clinical results of the three groups were compared.After 90 days of follow-up,the patients were divided into a good prognosis group(89 cases)and a poor prognosis group(69 cases)according to the modified Rankin scale(mRS),and the factors influencing the prognosis of the patients at 90 days were analyzed.Results The Na-tional Institutes of health stroke scale(NIHSS)score after thrombolysis in group A and group B was lower than that in group C,and the rate of short-term good prognosis was higher than that in group C(P＜0.05).There was no statistical sig-nificance in NIHSS score and short-term good prognosis between group A and group B(P＞0.05).The incidence of bleed-ing events in the three groups was 4(9.52％),7(13.21％),and 10(15.87％),respectively,with no significant differ-ence(x2=0.882,P＞0.05).In the poor prognosis group,age[(67.20±10.33)vs.(60.69±10.41)years],NIHSS score at admission[(12.35±3.50)points vs.(7.91±2.12)points],proportion of atrial fibrillation(17.39％vs.3.37％)and proportion of thrombolysis＞4.5-＜6.0 h after onset(53.62％vs.29.21％)were higher than in the good prognosis group(P＜0.05).Logistic regression showed that older age,high admission NIHSS score,atrial fibrillation,and thrombol-ysis time window＞4.5-＜6.0 h were independent risk factors for poor prognosis in AIS patients(P＜0.05).Conclusion Thrombolysis is beneficial within 4.5 hours of AIS onset.Age,NIHSS score on admission,atrial fibrillation,and time win-dow of thrombolysis may influence the 90-day prognosis of AIS patients.
维普
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