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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