The Evolution Of Syndrome Elements And Its Influencing Factors In Patients With Acute Cerebral Infarction After Intravenous Thrombolysis

Obj ective:This article is mainly aimed at patients with acute cerebral infarction by intravenous thrombolysis.The distribution of syndrome elements and the evolution over time within 14 days of onset,the related factors affecting neurological function score and short-term prognosis of patients,the correlation between clinical features and syndrome elements,such as infarct siteand short-term prognosis.lt is hoped that this research can provide a basis for assessing the patient’s condition and prognosis and a reference for the treatment of integrated Chinese and Western medicine.Methods:The information of 56 patients was recorded who were treated with intravenous rt-PA thrombolysis with the onset of cerebral infarction.Medical history collection and physical and chemical examination should be completed within 12 hours after onset,the MRI examination including the DWI sequence was completed within 72 hours,and then the infarct volume of the patient on the DWI sequence image was measured.The neurological function and living ability scale were assessed on the 1st,3rd,5th,7th and 14th day of the disease,and the information of TCM syndrome elements was collected at the same time.Collect various information and data for statistical analysis.Results:1.Risk factor:Among the risk factors associated with patients,hypertension(64.29%)and hyperlipidemia(35.71%)accounted for the highest proportion.Hyperhomocysteinemia(51.79%)accounted for the highest proportion of laboratory tests.2.The relationship between cerebral infarction volume and neurological function score:There was no significant correlation between the size of cerebral infarction and previous history and laboratory findings,but the correlation with ASPECTS score and NIHSS at each time point and mRS score were significant.The larger the infarct volume,the lower the ASPECTS score;The higher the neurological deficit score at each time point,the more severe the patient’s symptoms and the worse the prognosis.3.Neurological function score,prognosis and its influencing factors:The patient’s ASPECTS score was significantly negatively correlated with the NIHSS score at each time point.The higher the ASPECTS score,the lower the neurological deficit score,and the milder the patient’s symptoms,the better the prognosis.The NIHSS score before thrombolysis was significantly correlated with hyperuricemia.The patients with high uric acid had higher NIHSS score before thrombolysis,and the neurological deficit was more serious with more serious patient’s^condition.On the 14th day,the mRS score was significantly associated with smoking history and high D-dimer,namely,patients with a history of smoking and high D-dimer had a higher mRS score on the 14th day and a poorer prognosis.4.Characteristics of syndrome elements;In the evolution of the patient’s syndrome elements,the wind syndrome dominated in the first day,and the proportion of blood stasis syndrome and phlegm dampness syndrome were also higher.As the disease progressed,the internal wind syndrome rapidly decreased on the third day and disappeared on the 14th day.The phlegm-dampness syndrome and the blood stasis syndrome showed a downward trend,but the proportions were still high.As time passed,qi deficiency syndrome gradually increased,which became the most important syndrome element on the 7th day.The internal fire syndrome tended to the initial proportion after the raising on the fifth day,and the proportion of yin deficiency syndrome was always low with a downward trend with time.5.Correlation between clinical features and syndrome elements:There were significant differences in the syndromes of yin deficiency syndrome on the 7th and 14th day in the anterior and posterior circulation groups.It indicates that patients with posterior circulation infarction are more likely to have yin deficiency syndrome after the 7th day;the prognosis is better than that of patients with poor prognosis.There is a statistical difference between the 14th day of the internal fire syndrome and the 7th day of the qi deficiency syndrome,indicating that the patient with poor prognosis on the 14th day,the internal fire syndrome was more likely to occur,and the patients with better prognosis were more likely to have qi deficiency syndrome on the 7th day;cortical infarction and subcortical infarction,single infarction and multiple infarction patients had no significant difference in the characteristics of each syndrome;Conclusions:1.The larger the cerebral infarction volume,the lower the ASPECTS score,the higher the neurological deficit score at each time point,the more severe the patient’s symptoms and the worse the prognosis.2.In the early stage of cerebral infarction,the syndrome elements of patients are mainly evidence-based,with wind syndrome as the leading factor.The syndrome combinations of the two basic syndromes among wind,sputum,and sputum are the most,followed by the combination of three basic syndromes.After thrombolytic therapy,the syndrome combination forms gradually reduce,and the practical syndromes gradual reduce,with qi deficiency syndrome more prominent.3.Patients with posterior circulation infarction were more likely to have yin deficiency syndrome after the 7th day;patients with worse short-term prognosis on the 14th day were more likely to have internal fire syndrome;cortical infarction and subcortical infarction,single infarction and multiple infarction There were no significant differences in patient syndrome factors.