Abstract: Objective To explore the relationship between fibrinogen to albumin ratio (FAR) and the early neurological deterioration (END) after intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) in patients with acute ischemic stroke (IS). Methods A total of 156 patients with IS who received rt-PA intravenous thrombolysis were included. According to the occurrence of END, patients were divided into the END group (n=36) and the non-END group (n= 120). The baseline data were collected. Pearson test was used to analyze the correlation between the FAR of IS patients and the National Institutes of Health Stroke Scale (NIHSS) score before thrombolysis. The receiver operating characteristic (ROC) curve was used to analyze the value of relevant indicators to predict END after rt-PA intravenous thrombolysis in IS patients. Multivariate Logistic regression analysis was used to analyze the risk factors of END after rt-PA intravenous thrombolysis in IS patients. Results The incidence of END after rt-PA intravenous thrombolysis was 23.08% in patients with acute IS. The NIHSS score, blood sugar, white blood cell count, serum fibrinogen (FIB) level and FAR were significantly higher before thrombolysis in the END group than those of the non-END group, and the serum albumin (ALB) level was significantly lower in the END group than that of non-END group (P＜0.05). The FAR of IS patients was positively correlated with NIHSS score before thrombolysis (P＜0.05). The area under curve of FAR predicting END after rt-PA intravenous thrombolysis in IS patients was 0.806 (0.710-0.902), which was significantly higher than that of ALB［0.609(0.494-0.724)］and FIB［0.639 (0.524-0.754)］; but it was lower than the AUC of NIHSS score［0.963(0.931-0.994)］before thrombolysis (P＜0.05). The increased FAR and NIHSS score before thrombolysis were independent risk factors for END after rt-PA intravenous thrombolysis in IS patients (P＜0.05). Conclusion The increase of FAR is related to END after rt-PA intravenous thrombolysis, which can be used as a basis for predicting the occurrence of END after rt-PA intravenous thrombolysis in IS patients.

Key words: stroke, brain ischemia, tissue plasminogen activator, fibrinogen, serum albumin, thrombolytic therapy,
early neurological deterioration