目的：探讨基线甘油三酯-葡萄糖（triglyceride-glucose，TyG）指数与急性缺血性卒中（acute ischemic
stroke，AIS）患者静脉溶栓（intravenous thrombolysis，IVT）后早期神经功能恢复动态变化的关系。方法：回
顾性纳入在吉林省人民医院神经系统疾病诊疗中心接受标准IVT治疗的AIS患者。收集人口学、影像学及
实验室资料，计算基线TyG指数，并记录溶栓前（T0）、溶栓后即刻（T1）、溶栓后24 h（T2）及溶栓后7 d（T3）的
美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分。根据TyG指数中位
数将患者分为高TyG组和低TyG组，采用负二项混合效应模型分析TyG分组、时间及其交互作用对NIHSS
评分纵向变化的影响。结果：共纳入177例接受静脉溶栓治疗的AIS患者；与T1相比，T3时患者 NIHSS 评
分显著降低（IRR=0.72，95% CI 0.62～0.84，P＜0.001），而T2时变化差异无统计学意义（P=0.698）；TyG分组
主效应未见显著性（P=0.899）；时间与TyG分组之间存在显著交互作用，在T3时，高TyG组患者 NIHSS 评分
的改善幅度低于低TyG组（IRR=1.38，95% CI 1.12～1.69，P=0.002）；在协变量中，基线NIHSS与NIHSS动态
变化显著相关（P＜0.001），而年龄及性别未显示显著相关性。结论：在研究所观察的时间窗口内，基线TyG
指数升高与AIS患者IVT后早期神经功能恢复速度减慢相关，且该影响具有一定时间依赖性。TyG指数可
能可作为评估IVT患者早期恢复差异的潜在参考指标。
To explore the relationship between baseline triglyceride-glucose (TyG) index and
dynamic changes in early neurological recovery among patients with acute ischemic stroke (AIS) after
intravenous thrombolysis (IVT). Methods: Patients with AIS who received standard IVT at the Neurological
Disease Diagnosis and Treatment Center of Jilin Provincial People's Hospital were retrospectively enrolled.
Demographic, imaging and laboratory data were collected, and the baseline TyG index was calculated. National
Institutes of Health Stroke Scale (NIHSS) scores were recorded before thrombolysis (T0), immediately after
thrombolysis (T1), 24 hours after thrombolysis (T2) and 7 days after thrombolysis (T3). Patients were divided
into high-TyG group and low-TyG group according to the median TyG index. A negative binomial mixed-effects
model was used to analyze the effects of TyG grouping, time and their interaction on the longitudinal changes in
NIHSS scores. Results: A total of 177 AIS patients receiving intravenous thrombolysis were included.
Compared with T1, NIHSS scores were significantly reduced at T3 (IRR=0.72, 95%CI 0.62～0.84, P<0.001),
whereas no significant change was found at T2 (P=0.698). The main effect of TyG grouping was not statistically
significant (P=0.899). There was a significant interaction between time and TyG grouping. At T3, the magnitude
of improvement in NIHSS scores was smaller in the high-TyG group than in the low-TyG group (IRR=1.38, 95%
CI 1.12～1.69, P=0.002). Among covariates, baseline NIHSS was significantly associated with the dynamic
changes of NIHSS scores (P<0.001), while age and sex showed no significant correlation. Conclusion: Within
the observation time window of this study, elevated baseline TyG index is associated with slower early
neurological recovery after IVT in AIS patients, and this effect is partially time-dependent. The TyG index may
serve as a potential reference indicator for evaluating differences in early recovery among patients undergoing
IVT.
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