Analysis Of Prognosis And Risk Factors Of Intravenous Thrombolytic Therapy For Mild Ischemic Stroke

Objective:To explore the prognosis and risk factors of intravenous thrombolytic therapy with rt-PA in patients with acute mild ischemic stroke.Methods:There were one hundred and eighty four acute mild ischemic stroke patients whose NIHSS scores?5 points and onset time ? 12 hours in the department of neurology stroke center of The Fourth Affiliated Hospital of China Medical University from january2015 to September 2017.According to the different ways of treatment,the analysis was divided into the thrombolysis treatment group(n=84)and the non-thrombolysis treatment group(n=100).All patients had improved their baseline data,including gender,age,past medical history,laboratory tests.The imaging examinations of head CT,multi-mode head MRI,CTA,CTP and DSA were finished.Keep a record of the NIHSS scores on admission and discharge,keep a record of the m RS scores at hospital discharge and at 90 days.The effectiveness and safety of intravenous thrombolysis treatment was assessed by analyzing baseline data,short-term prognosis,long-term prognosis,stroke recurrence rate at 90 days,symptomatic intracranial hemorrhage(SICH)rate,mortality and other adverse events.The risk factors were analyzed by single factor and multifactor analysis.Result:1.There were no statistically significant differences in the baseline information including sex,age,blood glucose,blood pressure,smoking history,etc between the two groups.2.There were no statistically significant differences in the short-term prognosis,symptomatic intracranial hemorrhage(SICH)rate,stroke recurrence rate at 90 days and mortality in both groups.The long-term prognosis of both groupswas statistically different.3.The NIHSS scores(P=0.042)and the low density lipoprotein(LDL)(p=0.044)had significant differences by the single factor analysis in short-term prognosis in the intravenous thrombolysis group.Age(95%CI:0.897-0.997,OR=0.946,P=0.038)and the thrombolysis therapy time(95%CI: 0.543-0.991,OR=0.734,P=0.044)had significant differences by the multivariate analysis in short-term prognosisinthe intravenous thrombolysis group.4.According to the single factor analysis of of the long-term prognosis,Age(P=0.003),the thrombolysis therapy time(P=0.037),the NIHSS scores on adimission(P=0.031)and the NIHSS scores at discharge time(P=0)were statistically significant differentin the intravenous thrombolysis group.While in multivariate analysis of the long-term prognosis,age(95%CI: 0.833-0.974,OR=0.901,P=0.009)?the NIHSS score at discharge time(95%CI:0.561-0.94,P=0.015)and smoking history(95%CI: 0.013-0.923,OR=0.111,P=0.042)had significant differences.Conclusion:1.Intravenous thrombolytic therapy is relatively safe for the patients with mild ischemic stroke.The treatment of intravenous thrombolysis can improve the long-term prognosis of patients with mild ischemic stroke.2.The age and the thrombolysis therapy time were associated with the short-term outcome in mild stroke patients with intravenous thrombolytic therapy.3.The age,the NIHSS scores at discharge time and smoking history were associated with the long-term prognosis in mild stroke patients with intravenous thrombolytic therapy.