Analysis Of Related Factors Of Reocclusion After Intravenous Thrombolysis With Alteplase In Acute Cerebral Infarction

Objective:Reocclusion after intravenous thrombolysis can aggravate the deterioration of neurological function in patients,resulting in poor prognosis.The purpose of this study was to investigate the incidence of reocclusion after intravenous thrombolysis with a recombinant plasminogen activator(alteplase,rt-PA)in patients with acute cerebral infarction and related factors affecting reoocclusion after treatment,providing reference for prevention and treatment of reocclusion after thrombolysis.Methods:1.To collect clinical data of 66 patients who underwent rt-PA intravenous thrombolysis in the Department of Neurology and Cerebrovascular Diseases,Second Affiliated Hospital of Kunming Medical University from January 2018 to December 2018,including 5 cases with symptomatic intracranial hemorrhage,8 cases were not improved for other reasons,and a total of 53 patients were included.According tochanges in NHISS score(NHISS score increased by ≥ 2 points on the.basis of reduction of NHISS score≥2 points after thrombolysis),and symptomatic intracranial hemorrhage(sICH)was excluded by imaging.11 patients were found to have reocclusion.2.Collect demographic data,vascular risk factors,laboratory tests,clinical data,and imaging results of 53 patients.3.Using the mRs scale to assess the prognosis of patients at admission and discharge.4.Logistic regression was used to analyze risk factors for reocclusion after intravenous thrombolysis with alteplase.Results:A total of 66 patients received thrombolytic therapy,5 patients with symptomatic intracranial hemorrhage,and 11 patients with reocclusion(16.7%incidence of reocclusion).Logistic regression analysis showed that baseline D-dimer was a protective factor for the risk of reocclusion(OR=0.287,95%CI:0.085-0.969),and white blood cell count was a risk factor for reoccluison(OR=1.438,95).%CI:1.079-1.917).Conclusions:The incidence of revascular occlusion in this subject was 16.7%.Baseline D-dimer content before thrombolysis is a protective factor for reocclusion after thrombolysis.Baseline leukocyte level before thrombolysis is a risk factor for reocclusion after thrombolysis.