Analysis Of The Influencing Factors And Clinical Prognosis Of Vascular Recanalization In Patients With Acute Cerebral Infarction With Venous Thrombolysis

Objective: Acute ischemic stroke(AIS)is the most common cerebrovascular disease in China.Has become a serious restriction of the national quality of life,life cycle of cerebrovascular disease.Tissue-heavy plasminogen activator(rt-PA)is the most effective drug for acute ischemic stroke.The clinical prognosis of intravenous rt-PA thrombolysis is related to many factors,among which the recanalization of the diseased vessels is closely related to the clinical prognosis.This study will take the recanalization of the diseased vessels as the starting point to analyze the relevant factors affecting the vascular recanalization of AIS patients,so as to provide some guidance and reference for the clinical prognosis of the patients with thrombolysis.Methods: Retrospective analysis in January 2016 to December 2017 in xinjiang medical university first affiliated hospital emergency department,within 4.5 hours of stroke onset,90 cases of comply with the general clinical data of patients with venous thrombolysis,of which the lesion blood vessel whether recanalization after intravenous thrombolysis can be divided into recanalization group 39 cases,blood vessels not group of 51 cases,record and compare the general clinical data of patients,compared two groups of baseline data,using Logistic regression analysis of recanalization of independent factors.Neurological deficits were assessed using the national center for health scale(NIHSS)before,24 hours after,and 7days after surgery,and brain CT was performed 24 hours later.The incidence of postoperative intracranial hemorrhage was observed in both groups.The incidence of hemorrhage,mortality,neurological defects and early clinical outcomes were statistically analyzed.Results: Age,door to needle time(DNT),baseline NIHSS score,baseline blood sugar level,diabetes history,history of atrial fibrillation,thrombolysis improve ratio model,these indicators recanalization group are lower than group,the difference wasstatistically significant(P<0.05),will be the single factor into the multi-factor Logistic regression analysis showed that DNT(OR=1.020,95%CI: 1.004-1.036,P=0.016),baseline NIHSS score(OR=1.283,95%CI:1.091-1.509,P=0.003),and the improvement of thrombolysis mode(OR=0.213,95%CI:0.054-0.837,P=0.027)were independent factors affecting the recanalization after intravenous thrombolysis.The neurological function improvement at 24 h and the proportion of early clinical improvement at 7d in the re-vascularization group were also significantly higher than that in the non-vascularization group,and the mortality during hospitalization was also significantly different(P<0.05).Conclusion: The time from admission to intravenous thrombolysis,the severity of stroke and the change in the pattern of intravenous thrombolysis were all independent factors affecting the realization of recanalization after intravenous thrombolysis in acute ischemic stroke.Recanalization is a good predictor of clinical outcome after intravenous thrombolysis.The nerve function defect of the patients with revascularization was obviously improved,and the clinical prognosis was greatly improved.