To analyze the clinical efficacy of intravenous recombinant tissue-type plasminogen activator (rt-PA) thrombolytic therapy in stroke in young adults.

A retrospective study was performed on 102 young stroke patients (age≤ 45 years) admitted to Xuzhou Central Hospital from July 2010 to July 2019. All patients were treated with rt-PA after admission, and the Rankin Scale (mRS) was modified based on the 90-day clinical outcome and used to divide patients into either a good prognosis group (mRS score<2 points) or a poor prognosis group (mRS score≥ 2 points). The differences in variables were compared between the two groups using the χ² test or the t-test. Multivariate analysis was performed to identify the prognostic factors for young stroke patients.

All the 102 patients completed the 90-day clinical follow-up, of whom 55 had a good prognosis, accounting for 53.92% (55/102), and 47 had a poor prognosis, accounting for 46.08%(47/102). Univariate analysis demonstrated that education level, diastolic blood pressure before thrombolysis, blood homocysteine (Hcy), family genetic history, blood uric acid, and pre-thrombotic National Insitute of Health stroke scale (NIHSS) score differed significantly between the two groups (all P<0.05). Multivariate Logistic analysis confirmed that education level, pre-thrombotic systolic blood pressure, Hcy, family genetic history, blood uric acid, and pre-thrombotic NIHSS scores were related to poor prognosis of young stroke patients (P<0.05).

The poor prognosis of young stroke patients is closely related to lower education level, higher systolic blood pressure, Hcy, higher uric acid, genetic family history, and higher NIHSS score before thrombolysis. These factors should be clinically targeted to improve the prognosis of young stroke patients.