Risk factors related to prognosis of intravenous thrombolysis with alteplase in patients with acute cerebral infarction

doi:10.11817/j.issn.1673-9248.2022.05.009

Abstract

Abstract:

Objective

To analyze the prognostic risk factors of intravenous thrombolysis with alteplase in patients with acute cerebral infarction.

Methods

138 patients with acute ischemic stroke, admitted to Rizhao Hospital of Traditional Chinese Medicine from October 2018 to October 2020, were retrospectively included. The patients were divided into good prognosis group and poor prognosis group according to the modified Rankin scale. The age, sex, smoking, time from admission to start of intravenous thrombolysis (DNT), previous hypertension, previous diabetes, hyperlipidemia, atrial fibrillation, coronary atherosclerotic heart disease (CAD), National Institute of Health stroke scale (NIHSS) before treatment, history of stroke and transient ischemic attack, and other information were collected. The difference between the two groups was compared by by t-test, rank sum test or χ², and the factors of prognosis were analyzed by logistic regression.

Results

Among 138 patients, 75 had a good prognosis and 63 had a poor prognosis. The results of patients' prognosis by univariate analysis showed that there was no significant difference between the two groups in terms of age, gender, smoking, DNT, previous diabetes, hyperlipidemia, atrial fibrillation, CAD, and previous history of stroke and transient ischemic attack (P＞0.05); The NIHSS and the proportion of patients with previous hypertension in the two groups before treatment were compared [2.0 (0, 4.5) points vs 4.0 (2.0, 6.0) points; 32/75 vs 39/63], and the difference was statistically significant (Z=-3.28, P=0.001; χ²=5.45, P=0.024). Logistic regression analysis showed that NIHSS (OR=2.191, 95%CI: 1.058-4.537) and previous hypertension (OR=1.647, 95%CI: 0.811-3.345) before treatment were independent risk factors affecting the prognosis of patients.

Conclusion

NIHSS before treatment and previous hypertension impact the prognosis of patients and are independent risk factors for poor prognosis.

Key words: Acute ischemic stroke, Recombinant tissue plasminogen activator, Intravenous thrombolysis, Risk factors

Xiaoli Zhang, Xin Han, Kunqi Han, Shanshan Li, Xiangjing Liu, Dongcheng Xu, Lei Mou. Risk factors related to prognosis of intravenous thrombolysis with alteplase in patients with acute cerebral infarction[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(05): 338-341.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.11817/j.issn.1673-9248.2022.05.009

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2022/V16/I05/338

Figures/Tables 2

组别	例数	年龄（岁， $x ¯$ ±s）	女/男（例）	既往高血压（例）	吸烟（例）	NIHSS评分[分，M（Q_R）]	糖尿病（例）	心房颤动（例）	DNT（min， $x ¯$ ±s）	冠心病（例）	卒中和TIA病史（例）	高脂血症（例）
预后良好组	75	60.27±9.55	26/49	32	39	2.0（0，4.5）	32	31	107.23±41.78	12	39	41
预后不良组	63	62.57±10.24	30/33	39	25	4.0（2.0，6.0）	22	21	123.73±55.85	13	39	43
统计值		t=-1.79	χ²=2.38	χ²=5.45	χ²=2.09	Z=-3.28	χ²=0.86	χ²=0.93	t=-1.47	χ²=0.45	χ²=1.37	χ²=2.65
P值		0.073	0.122	0.024	0.148	0.001	0.353	0.334	0.140	0.504	0.242	0.103

组别	例数	年龄（岁， $x ¯$ ±s）	女/男（例）	既往高血压（例）	吸烟（例）	NIHSS评分[分，M（Q_R）]	糖尿病（例）	心房颤动（例）	DNT（min， $x ¯$ ±s）	冠心病（例）	卒中和TIA病史（例）	高脂血症（例）
预后良好组	75	60.27±9.55	26/49	32	39	2.0（0，4.5）	32	31	107.23±41.78	12	39	41
预后不良组	63	62.57±10.24	30/33	39	25	4.0（2.0，6.0）	22	21	123.73±55.85	13	39	43
统计值		t=-1.79	χ²=2.38	χ²=5.45	χ²=2.09	Z=-3.28	χ²=0.86	χ²=0.93	t=-1.47	χ²=0.45	χ²=1.37	χ²=2.65
P值		0.073	0.122	0.024	0.148	0.001	0.353	0.334	0.140	0.504	0.242	0.103

因素	β值	Sb值	Wald χ²值	P值	OR值	95%CI
既往高血压	0.499	0.361	1.905	0.020	1.647	0.811~3.345
NIHSS评分	0.784	0.372	4.456	0.035	2.191	1.058~4.537

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