Risk factors for early neurological deterioration after intravenous thrombolysis with Alteplase in patients with acute cerebral infarction
Objective:To analyze risk factors of early neurological deterioration(END)in patients with acute cerebral infarction after intravenous thrombolysis with Alteplase.Methods:The clinical data of 96 patients with acute cerebral infarction admitted to this hospital from January 2021 to January 2023 were retrospectively analyzed.After 24 hours of intravenous thrombolysis with Alteplase,the patients with the increase of the National Institutes of Health stroke scale(NIHSS)score of≥4 points compared with that before thrombolysis were determined as END.According to the occurrence of END,they were divided into END group(n=12)and non-END group(n=84).The risk factors of END after intravenous thrombolysis in the patients with acute cerebral infarction were analyzed by using univariate and Logistic regression.Results:There were no significant differences in gender,BMI,smoking history,drinking history,combined coronary heart disease,TOAST classification,time from onset to thrombolysis,PLT and Hb levels between the two groups(P>0.05).The proportions of the patients with age≥60 years old,combined hypertension,combined diabetes,complete occlusion of responsible major vessels,NIHSS score>21 at admission,GCS score≤8 and the WBC level in the END group were higher than those in the non-END group(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years old,combined diabetes mellitus,complete occlusion of responsible major vessels,GCS score≤8 points,NIHSS score>21 points at admission,and elevated WBC level were independent risk factors for END after thrombolysis in the patients with acute cerebral infarction(OR>1,P<0.05).Conclusions:The patients with acute cerebral infarction have a higher risk of END after intravenous thrombolysis with Alteplase.Age≥60 years old,combined diabetes mellitus,complete occlusion of responsible major vessels,GCS score≤8 points,NIHSS score>21 points at admission,and elevated WBC level are the independent risk factors for END after thrombolysis.
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