Correlation Between Non-traditional Lipid Indexes And Early Neurological Deterioration And Prognosis After Intravenous Thrombolytic Therapy In Acute Ischemic Stroke

Objective: To explore the relationship between non-traditional lipid indexes and early neurological deterioration and prognosis in patients with acute ischemic stroke after intravenous thrombolytic therapy.Methods: From September 2020 to September 2022,all patients of acute ischemic stroke(AIS)who received recombinant tissue plasminogen activator at the First Affiliated Hospital of China Medical University were collected.We observed patients for early neurological deterioration(END)and poor prognosis.Patients were divided into END group and non-end group according to the National Institute of Health stroke scale(NIHSS)score within 24 hours: END was defined as ≥4 NIHSS points increase within 24 hours after intravenous thrombolytic therapy.Patients were divided into two groups according to the 90-day Modified Rankin Scale(m RS)score: good prognosis group(m RS≤2),poor prognosis group(m RS>2).SPSS26.0 statistical software was used in this study.Univariate analysis was used to select related factors in two groups,and then binary logistic analysis was used to explore the relationship between non-traditional lipid profiles and END and prognosis in AIS patients after intravenous thrombolytic therapy.Results: 1.A total of 310 patients with AIS who received intravenous thrombolytic therapy were collected in this study.After following the strict inclusion and exclusion criteria,297 patients were included.2.There were 51 people(17.2%)in the END group and 246 people(82.8%)in the non-END group.Univariate analysis showed no significant difference were observed between non-traditional lipid profiles and END.3.There were 213 patients(71.7%)in the good prognosis group and 84 patients(28.3%)in the poor prognosis group.Multivariate logistic regression analysis showed that RC,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C and Apo B/Apo AI were independently associated with poor prognosis(RC: OR=0.200,95% CI= 0.048-0.828;TC/HDL-C: OR=0.684,95%CI=0.514-0.910;TG/HDL-C: OR= 0.455,95%CI=0.286-0.724;LDL-C/HDL-C: OR=0.693,95% CI=0.497-0.967;Apo B/Apo AI: OR=0.216,95%CI=0.051-0.915,P<0.05).ROC analysis showed that RC,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,Apo B/Apo AI have predictive ability for the prognosis of AIS after intravenous thrombolytic therapy.The AUC value of TG/HDL-C was the largest,and its predictive value was better than other non-traditional lipid indexes.Conclusion: 1.No significant relationship was observed between nontraditional lipid indexes and END in AIS patients with intravenous thrombolytic therapy.2.Low RC,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,Apo B/Apo AI were independently associated with poor prognosis in AIS patients with intravenous thrombolytic therapy.RC,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,Apo B/Apo AI have predictive ability for the prognosis of AIS after intravenous thrombolytic therapy.TG/HDL-C was a better predictor than other non-traditional lipid indexes.