Analysis Of Gender Differences And Related Factors Of Rt-PA Intravenous Thrombolysis In Patients With Ischemic Stroke

ObjectiveTo explore the influence of gender factors on the clinical efficacy of patients receiving rt-PA intravenous thrombolysis within 4.5 hours of onset,and analyze the factors that influence the outcomes of patients.Methods1.Retrospective analysis of Tianjin Huanhu Hospital(Tianjin Brain Hospital Department of Neurology)from May 1,2016 to July 2016 were accepted 302 patients with acute ischemic stroke rt-PA intravenous thrombolytic therapy patients,these patients from the onset to receive intravenous thrombolytic treatment time in 4.5 hours.2.Records of all patients with sex,age,weight,laboratory data,medical history,history of oral medicine history,patients at the beginning of the 1 rt-PA hours after intravenous thrombolysis,24 hours after intravenous thrombolytic therapy in patients with rt-PA,7 days after treatment the scores of NHISS(the National Institutes of Health Stroke Scale),at the beginning of treatment and 3 months follow-up in patients with modified Rankin score(the modified,Rankin scale,m RS),ischemic stroke TOAST type(trail of Org 10172 in acute stroke treatment,TOAST),neck vascular ultrasound(Cervical vascular ultrasound)found in the neck vascular plaque,computed tomography angiography(computed tomographic angiography,CTA)or magnetic resonance angiography(magnetic resonance angiograp head Hy,MRA)the degree of stenosis of extracranial vessels found the incidence of recorded clinical outcomes in patients with intravenous thrombolysis after treatment and adverse complications,analyze the gender baseline data,disease characteristics,risk factors,and the differences between clinical prognosis,and explore the related factors affecting the good prognosis in the near future.Results1.This study included admission from May 2016 to July 2016 in the neurology department of Tianjin Huanhu Hospital for 302 patients with acute ischemic stroke rt-PA intravenous thrombolytic therapy patients,including 208 cases of male patients,94 female patients.The age of male patients with 61.2 + 10.49 years old,female patients age 64.6 + 10.29 years old,the average age of onset in female patients is higher than male groups of patients and more than 60 years old were higher than the proportion of male patients(68.1% VS 55.7%,p=0.026).Female patients with neurological impairment Men to women with OTT.Compared with male patients.The longer time for patients in the two groups of laboratory test results found that male homocysteine(HCY)level is higher than that of female patients,female patients receiving intravenous thrombolytic therapy of high sensitivity C reactive protein(hs-CRP)level is higher than the male patients.There was no significant other laboratory indicators of differences.2.Male patients suffering from hypertension,smoking,drinking,the proportion of patients is higher than that of female patients,female group in patients with atrial fibrillation and other cardiovascular disease is significantly higher than male patients.Patients receiving thrombolytic therapy within 24 hours before taking antihypertensive drugs in the highest proportion,two groups of patients taking antihypertensive drugs,lipid-lowering drugs,antidiabetic drugs,anticoagulant,antithrombotic drugs had no significant difference.3.In female patients,incidence of cardiogenic cerebral embolism than the male group,large artery atherosclerosis stroke ratio is lower than the male patients;and gender groups in perforator vascular lesions,no clear etiology and other reasons caused by cerebral infarction had no significant statistical difference.After MRA or CTA examination found that male patients with mild stenosis group head artery were higher than female patients,head artery occlusion occurred less than female patients.Two groups of patients with head artery stenosis,moderate stenosis,moderate stenosis occurred in the proportion of similar.4.After intravenous thrombolysis and venous thrombolysis after 7 days,the female NIHSS were higher than those of the female patients.Intravenous thrombolytic therapy after 24 hours and 7 days,the male group with better prognosis than women.Patients were followed up for 3 months,there was no significant difference in the proportion of patients with good prognosis and mortality of female and male patients two groups.All patients had symptoms of intracranial hemorrhage occurred in the proportion of adverse reactions,no significant difference between the two groups.5.Older age,longer OTT time,initial NIHSS score higher on admission,high prevalence of atrial fibrillation,vascular occlusion is female group patients with neurological prognosis may be independent risk factors.Smoking history and drinking history,hypertension,carotid artery plaque is affecting the male group patients with neurological prognosis may the independent risk factors.Conclusion1.For different gender of patients with acute ischemic stroke,the gender factors caused the pathogenesis and risk factors are different2.For female patients with acute ischemic stroke,the short-term clinical outcome was better than that of male patients.3.There was no significant difference between male and female patients with acute ischemic stroke after intravenous thrombolytic therapy.4.For women with ischemic stroke after intravenous thrombolytic therapy,the long-term prognosis was significantly different than that of male patients.