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Influencing factors of clinical prognosis in patients with acute ischemic stroke treated with intravenous thrombolysis |
WU Guo-xin1 HE Jia-cheng1 LIU Zhi-yu1 YE Yi1 FENG Yuan-bo1 WU Zhi-xin2 GUAN Zi-yun1▲ |
1. Department of Emergency, Foshan Nanhai District People′s Hospital
2. ICU, Foshan Traditional Chinese Medicine Hospital |
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Abstract Objective To investigate the clinical prognostic factors of patients with acute ischemic stroke treated with intravenous thrombolysis. Methods A total of 260 patients with acute ischemic stroke admitted to People′s Hospital of Nanhai District from October 2017 to October 2019 were retrospectively selected as the research subjects. According to the improved clinical outcome of thrombolysis, the patients were divided into good prognosis group (130 cases) and poor prognosis group (130 cases), and both groups were treated with Alteplase. The nerve defect scores of the two groups were compared, and the factors affecting the prognosis of acute ischemic stroke were analyzed. Results After 2 d,1 week and 1 month of treatment, neurological deficit scores in the poor prognosis group were higher than those in the good prognosis group, the difference was statistically significant (P<0.05). Univariate analysis results indicated that age,weight, history of hypertension, length of hospital stay, history of diabetes mellitus, history of atrial fibrillation and systolic blood pressure before thrombolysis were compared between the two groups, the differences were statistically significant (P<0.05). Multivariate analysis indicated that age≥60 years old (β=1.457,OR=4.257,95%CI=2.365-6.954), body weight ≥65 kg (β=0.684,OR=5.236,95%CI=1.028-5.687), length of hospital stay≥10 d (β=0.747,OR=5.326,95%CI=4.395-7.893), history of hypertension (β=1.442,OR=4.091,95%CI=3.235-4.573), history of diabetes (β=1.573,OR=6.413,95%CI=5.691-8.461), history of atrial fibrillation (β=1.131,OR=4.574,95%CI=1.496-9.481) and systolic blood pressure before thrombolysis ≥140 mmHg (β=1.215,OR=3.591,95%CI=2.491-6.324) were risk factors for poor prognosis in patients with acute ischemic stroke (P<0.05). Conclusion The clinical effect of intravenous thrombolysis in the treatment of acute ischemic stroke is significant, which can reduce the nerve defect in patients. The risk factors for poor prognosis in patients with acute ischemic stroke need active intervention to improve the quality of life of patients
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