Fang Jungang, Sun Hui, Lu Xinyu
People's Hospital Affiliated to Jiangsu University, School of Medicine Jiangsu University, Zhenjiang, China.
Hospital Affiliated to Jiangsu University, Zhenjiang, China.
Front Neurol. 2025 Aug 5;16:1555708. doi: 10.3389/fneur.2025.1555708. eCollection 2025.
The aim of this study is to examine the potential risk factors contributing to early neurological deterioration (END) following intravenous thrombolysis in patients diagnosed with acute ischemic stroke (AIS).
Clinical data was gathered from AIS patients who underwent intravenous thrombolysis at the Affiliated People's Hospital of Jiangsu University between January 2020 and December 2023. Patients were subsequently categorized into two groups based on the occurrence of END within 24 h post-thrombolysis: the END group and the non-END group. A comparative analysis of the clinical data from both groups was conducted. The application of Multivariate Logistic regression facilitated the identification of independent risk factors and the construction of a nomogram prediction model.
The study encompassed a total of 249 AIS patients, with 32 patients (12.9%) developing END. The multivariate analysis revealed that NIHSS Score immediately after thrombolysis ( < 0.001), the Trial of Org 10172 in Acute Stroke Treatment (TOAST) typing of large artery atherosclerosis ( = 0.025), and a prior history of diabetes ( = 0.023) were independent risk factors for the development of END post-thrombolysis. A nomogram was constructed to generate the ROC curve, and the AUC value was 0.809 (95% CI, 0.732-0.885).
This nomogram, which demonstrates good discrimination and high predictive value, identifies NIHSS score immediately after thrombolysis, TOAST classification of large artery atherosclerosis, and a history of diabetes as independent risk factors for early neurological deterioration (END) in acute ischemic stroke (AIS) patients receiving intravenous thrombolysis.
本研究旨在探讨急性缺血性脑卒中（AIS）患者静脉溶栓后早期神经功能恶化（END）的潜在危险因素。
收集2020年1月至2023年12月在江苏大学附属人民医院接受静脉溶栓的AIS患者的临床资料。根据溶栓后24小时内END的发生情况，将患者分为两组：END组和非END组。对两组临床资料进行对比分析。应用多因素Logistic回归分析确定独立危险因素，并构建列线图预测模型。
本研究共纳入249例AIS患者，其中32例（12.9%）发生END。多因素分析显示，溶栓后即刻美国国立卫生研究院卒中量表（NIHSS）评分（<0.001）、急性卒中治疗中组织型纤溶酶原激活剂试验（TOAST）分型为大动脉粥样硬化（=0.025）以及既往糖尿病史（=0.023）是溶栓后发生END的独立危险因素。构建列线图并生成ROC曲线，AUC值为0.809（95%CI，0.732-0.885）。
该列线图具有良好的区分度和较高的预测价值，确定了溶栓后即刻NIHSS评分、TOAST大动脉粥样硬化分型以及糖尿病史是接受静脉溶栓治疗的急性缺血性脑卒中（AIS）患者早期神经功能恶化（END）的独立危险因素。
