Effects of Basal Ganglia EPVS on Short-Term Prognosis of Patients with AIS After Intravenous Thrombolysis with rt-PA

ZHANG Hechuan; ZHOU Hemin; FENG Wenxian

doi:10.3969/j.issn.1004-437X.2024.21.013

Abstract：Objective To evaluate the effects of enlarged perivascular spaces(EPVS)from basal ganglia(BG)on short-term prognosis of patients with acute ischemic stroke(AIS)after intravenous thrombolysis with human recombinant tissue plasminogen activator(rt-PA).Methods A total of 101 patients with AIS who received intravenous thrombolytic therapy with rt-PA in Zhumadian Central Hospital from March 2021 to March 2022 were selected as subjects.After MRI examination,all patients were scored for the number of EPVS,and the severity was divided according to the EPVS score:0-1 points were classified as no or mild group,2-4 points were classified as severe group.Prognostic evaluation was conducted based on the improved Rankin(mRS)scoring scale.Follow-up data were compiled,and the short-term prognosis of 101 patients within 90 days was counted,and logistic regression was used to analyze the related factors affecting the short-term prognosis of patients with AIS.Results Within 90 days after early rt-PA intravenous thrombolysis treatment,3 out of 101 AIS patients died,67 patients had the mRS scores of 0-12 points(in the group with good prognosis),the mRS score of 31 patients were 3-5 points(poor prognosis group).The group with good prognosis had a higher age of≥60 years,smoking history,concomitant atrial fibrillation,severe BG-EPVS score,and a time from onset to thrombolysis of≥4.5 hours compared to the group with poor prognosis(P＜0.05).There was no statistically significant difference between the two groups in terms of gender,alcohol consumption,concomitant hypertension,concomitant hyperlipidemia,and infarct site(P＞0.05).The results showed that age 60 years,severe BG-EPVS score,and onset to thrombolysis time ≥4.5 hours were associated with 1.919 times,1.5151 times,and 1.436 times higher risks of poor prognosis compared to age＜60 years,no/mild BG-EPVS score,and onset to thrombolysis time＜4.5 hours,respectively(P＜0.001).Conclusion AIS patients with higher BG-EPVS scores have a relatively higher risk of poor short-term prognosis after receiving rt-PA intravenous thrombolysis.By evaluating the BG-EPVS score,it has certain guiding value for clinical evaluation of the short-term prognosis of AIS thrombolytic therapy and the establishment of active intervention plans.