ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ NGƯỜI BỆNH NHỒI MÁU NÃO NHẸ ĐƯỢC TIÊU HUYẾT KHỐI

Abstract

The use of intravenous thrombolysis for patients with minor ischemic stroke remains a matter of ongoing debate. This study aimed to evaluate the clinical and paraclinical characteristics, as well as treatment outcomes, of minor stroke patients receiving intravenous thrombolysis with alteplase at the Stroke Center, Bach Mai Hospital, from November 2023 to November 2024. This was a retrospective, observational, longitudinal study. A total of 36 eligible patients were enrolled out of 932 minor stroke patients admitted within the first 24 hours of symptom onset. The results showed: mean age was 66.33 ± 9.37 years; 66.7% were male; 63.9% arrived within the first 3 hours; 61.1% had infarctions located in the basal ganglia-periventricular region; early neurological deterioration occurred in 36.1% of patients; the rate of hemorrhagic transformation was 2.8%; 90-day mortality was 2.8%; and 80.6% achieved a favorable functional outcome mRS score 0–1 at 90 days. Multivariable logistic regression analysis identified two factors significantly associated with favorable outcomes: early neurological deterioration (OR 0.462, 95% CI: 0.257–0.830; p < 0.001) and low-density lipoprotein cholesterol level (OR 0.316, 95% CI: 0.110–0.905; p = 0.032). Conclusion: Intravenous thrombolysis in patients with minor ischemic stroke may lead to a high rate of favorable functional outcomes. However, early neurological deterioration and LDL-C levels should be considered important prognostic factors when selecting and monitoring patients