Factors Influencing Early Efficacy Of Intravenous Thrombolysis In Acute Ischemic Stroke

Objects: To observe the efficiency and safety of Intravenous thrombolysis in cerebral ischemia,and analysis variable associated with early outcomes in patients with acute ischemic stroke who received alteplaseMethods: Collected the clinical data of acute ischemic stroke patients who have received intravenous thrombolysis and were hospitalized at Neurology Department of the Fist Affiliated Hospital of Wannan Medical College from January 2012 to December 2015,including age,blood pressure,the National Institute of Health stroke scale(NIHSS),onset to start of treatment time,history of cardiovascular and cerebrovascular diseases,such as hypertension,atrial fibrillation,coronary heart disease(CHD),routine blood test,blood biochemical and blood coagulation test results.According to the improvment of functional defect symptoms in 24 hours after intravenous thrombolysis therapy,we divided all patients into two groups,effiecacy group and ineffiecacy group.The statistical analysis was performed with SPSS for Windows,version 19.0.The measurement dates were expressed as mean±standard deviation or Median,and were compared by t test or the Mann-Whitney U test between two groups,while the enumeration dates were expressed as number(percentage),and compared by the Fishers Exact Test.The Logistic regression was used to analyse the related factors of early outcome in acute ischemic stroke patients treated with intravenous thrombolysis.Results: 35 patients were included in the analysis.single-facter analysis showed that by comparing the effective group(n=16)with the ineffective group(n=19),blood glucose level before thrombolysis(5.87 vs 6.85,p<0.05),NIHSS scores prior to thrombolysis(11 vs 16,p<0.05),and onset to start of treatment time(3.13 vs 3.5,p<0.05),were statistically significant.Logistic regression analysis showed that low NIHSS before thrombolysis(OR=0.729,95%CI 0.550~0.966,p<0.05),and the short time from the symptoms onset(OR=0.060,95%CI 0.005~0.736)are the independent predictor of good early outcome after thrombolysis.Conclusion: Treated with alteplase in 4.5 hours before the onset of acute ischemic stroke would improve the functional deficit.blood glucose level before thrombolysis,NIHSS scores prior to thrombolysis,and onset to start of treatment time are factors that affect early functional improvement with thrombolysis treatment.Lower NIHSS score andshorter time from the symptoms onset are the prognostic factors of the thrombolysis therapy.