Clinical Analysis Of Outcome After Rt-PA Thrombolysis Of Acute Ischemic Stroke In65Patients

Objective: To analyse the risk factors、incidence、the distribution oftime and CT classification of intracerebral hemorrhage(ICH) in acuteischemic stroke following rt-PA thrombolysis and to calculate for clinicaldeterioration at24hours and3-Month outcome after stroke onset.Methods: We retrospectively collected65cases of acute ischemicstroke patients who received intravenous or intra-arterial recombinant tissueplasminogen activator (rt-PA) thrombolytic therapy within4.5h after strokeonset.All patients had a control CT scan after24hours or immediately incase of rapid and severe clinical deterioration.We observed the classification,distribution of time and clinical symptoms of ICH followingthrombolysis,and analysed the baseline feature,risk factors,laboratoryexamination, clinical evaluation, and clinical outcome of the patients.Results:1. Intracerebral hemorrhage occurred in13.8%of65patients.5patientssuffered symptomatic intracerebral hemorrhage(SICH)(7.7%),4onesexhibited asymptomatic cerebral hemorrhage(aSICH)(6.1%).2patients suffered haemorrhagic infarction type1（3.1%）,2ones exhibitedhaemorrhagic infarction type2（3.1%）,5patients suffered parenchymalhematoma type2（7.6%），no parenchymal hematoma type1.2. The clinical manifestation of ICH after thrombolysis mainly includedheadache, decreased muscle strength, falling in consciousness, nausea andvomiting, increased aphasia，or no performance.The parenchymal hematomatype2(PH-2) all occurred within0-12h after thrombolysis，haemorrhagicinfarctions（HI）was mainly within12-36h.3. Compared with non ICH，HI did not increase the risk of earlyneurological deterioration and3months outcome,PH-2was associated withan increased risk for deterioration at24hours after stroke onset and forfavorite outcome、 disability、death at3months.4. In multivariable analysis, ICH was associated with high bloodglucose(OR=2.214，95%CI1.219-4.018，P=0.009)、low platelet count(OR=0.887，95%CI0.812-0.969，P=0.008).Conclusions:1. The frequency of ICH was13.8%,SICH was7.7%,and aICH was6.1%.2. ICH mainly occurred within24hours following thrombolysis,ICHwas more often found in4-4.5h after stroke onset following thrombosisthan that in0-3h.4.The risk factors of ICH was low platelet and high blood glucose.