Risk Factor For Patients Treated By Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator In Acute Cerebral Infarction

ObjectiveTo investigate risk factors for patients treated by intravenous thrombolysis with recombinant tissue plasminogen activator in acute cerebral infarction.MethodsAll50patients with acute cerebral infarction were treated by intravenous rt-PA within4.5hours from stroke onset. The modified Rankin scale score was used to measure the outcome after90days. The clinic records and laboratory datas of pre-and post-treatment were statistically analyzed between favorable prognosis group and unfavorable prognosis group to find out factors that will given further Logistic regression analysis to find out independent prognostic factors.Results1:50of thrombolysis patients with favorable prognosis group17cases(34.0%), unfavorable prognosis group33cases(66.0%).23(46%),15(30%),6(12%),4(8%),2(4%) were classified as large-artery atherosclerosis, cardioembolism, small-artery occlusion, undetermined etiology, other demonstrated reasons. A total of21patients NIHSS score≥15points,16cases of middle cerebral artery occlusion,2cases of internal carotid artery occlusion,3cases of posterior circulation infarction.2:Results from univariate analysis showed that poor prognosis were associated with NIHSS score (P=0.001), baseline blood glucose (P=0.001), atrial fibrillation (P=0.035) and baseline diastolic blood pressure (P=0.001). Results from logistic regression analysis showed that NIHSS score>15points (OR=1.752,95%CI1.452-3.852, P=0.022), blood glucose>11.1mmol/L (OR=2.087,95%CI2.207-7.269, P=0.031) are independent risk factors. 3:17patients(34.0%) suffered from hemorrhagic transformation(HT) after thrombolysis.There were diffent subtypes of HT between favourable prognosis group and unfavourable prognosis group.The former main occurred subtype of hemorrhagic infarction(HI),the latter main occurred subtype of parenchymal hemorrhage(PH),2patients died due to PH-2.ConclusionThrombolysis with severe neurological deficit and/or high blood glucose received poor prognosis.