Abstract: This study explored the relationship between the transcranial Doppler (TCD) assessment of cerebral ischemia thrombolytic classification (TIBI), TCD blood flow reversal and the prognosis of patients with acute middle cerebral artery (MCA) occlusive stroke. Chosen 144 MCA occlusive stroke patients as the research objects, all patients were treated with intravenous alteplase thrombolysis. According to the prognosis of patients within 90 days of onset, they were divided into a good prognosis group with 98 cases and a poor prognosis group with 46 cases, and compared the cerebral ischemia thrombolysis classification (TIBI) and TCD blood flow reversal before and after thrombolysis between the two groups. Re-examined 24 hours after the operation, the TIBI blood flow classification distribution of the good prognosis group was better than that of the poor prognosis group (P<0.05). The AUC values of TIBI blood flow improvement and TCD blood flow reversal rate predicted the prognosis of patients with MCA occlusive stroke after thrombolytic therapy were 0.757 and 0.578, respectively. The higher NIHSS scores, diabetes, coronary heart disease, and atrial fibrillation at admission would significantly increase the risk of poor prognosis on admission (P<0.05). After thrombolysis, TIBI blood flow was improved and TCD blood flow was improved and reversal reduced the risk of poor prognosis in patients (P<0.05). Through early observation of TIBI blood flow improvement after thrombolytic therapy and TCD blood flow reversal could have a certain clinical value for evaluating the prognosis of patients, and the two can effectively complement each other.

Key words: transcranial Doppler, middle cerebral artery occlusion, stroke, prognosis