Abstract: Objective To explore the related factors affecting the efficacy of urokinase intravenous thrombolysis in the treatment of ischemic stroke at hyperacute stage in the elderly patients. Methods The clinical data of 185 elderly patients with hyperacute ischemic stroke who received intravenous thrombolytic therapy with urokinase in our hospital from 2009 to 2019 were retrospectively analyzed. The score of National Institute of Health stroke scale (NIHSS) decreased ≥1 point on the 7th day of admission than that at admission was defined as thrombolysis improvement, the patients were divided into the improvement group (n=62) and the non-improvement group (n=123). The influencing factors that affect the efficacy of intravenous thrombolysis with urokinase were evaluated by multivariate Logistic regression analysis. Results The median NIHSS score of the patients before thrombolysis was 8.90, compard with 6.03 on the 7th day after thrombolysis (P<0.05). There was a significant difference in the proportion of patients with atrial fibrillation (AF) between the improvement group and the non-improvement group (P<0.05). Multivariate Logistic regression analysis showed that AF and hyperglycemia before thrombolysis were the independent risk factors for poor efficacy of urokinase intravenous thrombolysis in the elderly patients with acute ischemic stroke (OR=4.71,95％CI: 2.26-10.18,P＜0.01;OR=1.10,95％CI: 1.01-1.20,P＝0.02). Conclusions Intravenous thrombolytic therapy with urokinase shows effects in the elderly patients with hyperacute ischemic stroke, but shows no effects in the patients with AF or hyperglycemia before thrombolysis.

Key words: ischemic stroke, intravenous thrombolysis, urokinase, aged, atrial fibrillation