Objective To explore the risk factors of early neurological deterioration(END)after intravenous thrombolysis with recombinant tissue plasmin activator(rt-PA)in acute ischemic stroke(AIS)patients.Methods This study was a retrospective analysis of 268 patients with acute ischemic stroke who received rt-PA intravenous thrombolysis treatment from January 2019 to October 2022.These patients were divided into END group(90 cases)and non-END group(178 cases)based on whether early neurological deterioration occurs within 24 hours after thrombolysis.Clinical data from two groups of patients was collected.Univariate analysis was used to compare the baseline data of the two groups,and multivariate logistic regression was used to clarify the independent risk factors for END after intravenous thrombolysis in acute ischemic stroke patients.Results Univariate analysis showed that compared with patients in the non-END group,patients in the END group had higher baseline NIHSS scores,higher baseline systolic blood pressure,higher baseline diastolic blood pressure,higher proportion of hemorrhagic transformation after thrombolysis,and higher proportion of new infarcts in the inner capsule area and large artery atherosclerosis(TOAST classification).The differences were statistically significant(P＜0.05).Multivariate logistic analysis showed that only baseline NIHSS score[OR(95％CI)=1.075(1.015-1.139),P=0.013]and new infarcts in the inner capsule area[OR(95％CI)=1.831(1.048-3.199),P=0.033]were independently related to the occurrence of END after intravenous thrombolysis in acute ischemic stroke patients.Conclusions High baseline NIHSS score and new infarcts in the inner capsule area were independent risk factors for END after intravenous thrombolysis in acute ischemic stroke patients.
关键词
急性缺血性卒中/静脉溶栓/早期神经功能恶化/病灶部位/穿支动脉
Key words
acute ischemic stroke/intravenous thrombolysis/early neurological deterioration/location of lesion/perforating artery
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