Influencing Factors Analysis Of Ischemic And Hemorrhagic Early Neurological Deterioration After Rt-PA Intravenous Thrombolysis In Patients With Acute Cerebral Infarction

Objective To explore the influencing factors of ischemic and hemorrhagic early neurological deterioration(END)in patients with acute cerebral infarction after rt-PA intravenous thrombolysis.Methods The clinical data of hospitalized patients who were diagnosed with acute cerebral infarction and received rt-PA intravenous thrombolysis in the Department of Neurology of the Second Affiliated Hospital of Anhui Medical University from January2019 to May 2020 were collected.A total of 121 cases met the inclusion criteria,according to whether it occurred END and classification group,of which 88 people were in the no-END group,21 people were in the ENDi group,and 12 people were in the ENDh group,record the levels of laboratory and imaging related indicators in each group,and use univariate analysis and logistic regression model to determine the risk factors of ENDi and ENDh after rt-PA intravenous thrombolysis in patients with acute cerebral infarction.Results The results of univariate analysis showed that compared with patients in the no-END group,the fasting blood glucose level and NIHSS before thrombolysis of the ENDi group and ENDh group were statistically significant(P<0.05).Compared with the no-END group,ASPECTS≤7 points and intracranial occlusion of the ENDi group were statistically significant(P<0.05).Taking antiplatelet or anticoagulant drugs and total cholesterol level of the ENDh group were statistically significant(P<0.05).Logistic regression analysis showed that large artery occlusion,ASPECTS≤7 points,and elevated fasting blood glucose levels were independent risk factors for ENDi;taking antiplatelet or anticoagulant drugs and high NIHSS score before thrombolysis were independent risk factors for ENDh,total cholesterol level is a protective factor for ENDh.Conclusion For patients undergoing rt-PA intravenous thrombolysis after acute cerebral infarction,aortic occlusion,ASPECTS≤7 points,and elevated fasting blood glucose levels may increase the risk of ENDi.Take antiplatelet or anticoagulant drugs and a higher NIHSS score before thrombolysis can increase the risk of ENDh,and a higher level of total cholesterol can reduce the risk of ENDh.