Effects of Ultra-early Alteplase Intravenous Thrombolysis in Patients with Acute Cerebral Infarction and the Influencing Factors of Deterioration After Improvement

Abstract

Objective: To analyze the effects of ultra-early alteplase (rt-PA) intravenous thrombolysis in patients with Acute Cerebral Infarction (ACI) and the influencing factors of deterioration after improvement. Methods: A total of 70 patients with ACI treated by rt-PA intravenous thrombolysis in our hospital from January 2014 to December 2016 were selected as the observation group, and another 90 patients with ACI who only received conventional treatment were selected as the control group. The status of neurological impairment was evaluated with the National Institutes of Health Stroke Scale (NIHSS) and the prognosis was evaluated with the Barthel Index (BI) and modified Rankin Scale (mRS). The incidence of complications was statistically analyzed. Patients in the observation group were divided into the deterioration group (n=9) and the non-deterioration group (n=61). the clinical data were collected for univariate analysis and factors with significant differences were analyzed by Logistic regression analysis. Results: Before treatment, there were no significant differences between the two groups in NIHSS score, BI and mRS score, while after treatment, the above-mentioned indexes were significantly improved, and the improvement was more obvious in the observation group than the control group. Multivariable Logistic regression analysis showed that age, previous history of atrial fibrillation, late thrombolysis, high NIHSS score before thrombolysis, low white blood cell count and total anterior circulation infarction were independent risk factors for deterioration after improvement. Conclusion: Ultra-early rt-PA intravenous thrombolysis can quickly correct the status of cerebral ischemia and hypoxia and save the damaged neurological function in patients with ACI, and attention should be paid to the independent risk factors for deterioration after improvement.