甲状腺功能亢进并发急性脑梗死患者临床特点及其静脉溶栓治疗的预后和安全性评价

发布时间：2018-06-03 13:43

本文选题：急性脑梗死 + 重组组织纤溶酶原激活剂　；参考：《吉林大学学报(医学版)》2017年02期

【摘要】：目的:分析甲状腺功能亢进(甲亢)并发急性脑梗死患者的临床特点,评价在溶栓时间窗内甲亢并发急性脑梗死患者静脉溶栓治疗的预后和安全性。方法:回顾性分析重组组织纤溶酶原激活剂(rt-PA)阿替普酶注射溶栓治疗的急性脑梗死患者的临床资料,根据是否并发甲亢,筛选出并发甲亢患者41例(甲亢组)和非甲亢患者160例(非甲亢组),比较2组患者一般资料、脑梗死面积和颅内出血情况。结果:首次美国国立卫生研究院卒中量表(NIHSS)评分甲亢组患者高于非甲亢组(P0.05);2组患者7dNHISS评分和90d改良Rankin量表(mRS)评分比较差异无统计学意义(P0.05);2组不同梗死面积患者所占比例比较差异有统计学意义(P0.05),甲亢组大面积脑梗死患者占51.2%,非甲亢组大面积脑梗死患者占27.5%;甲亢组患者无症状颅内出血发生率高于非甲亢组(P0.05),症状性颅内出血及蛛网膜下腔出血发生率2组间比较差异无统计学意义(P0.05)。结论:甲亢并发急性脑梗死患者静脉溶栓可获益,不增加症状性颅内出血及蛛网膜下腔出血发生率。
[Abstract]:Objective: to analyze the clinical features of hyperthyroidism (hyperthyroidism) complicated with acute cerebral infarction (ACI) and to evaluate the prognosis and safety of intravenous thrombolytic therapy for hyperthyroidism complicated with acute cerebral infarction (ACI) in the thrombolytic time window. Methods: the clinical data of patients with acute cerebral infarction treated with recombinant tissue plasminogen activator (rt-PA) by intravenous thrombolytic therapy were analyzed retrospectively, according to whether they were complicated with hyperthyroidism. 41 patients with hyperthyroidism (hyperthyroidism group) and 160 patients with non-hyperthyroidism (non-hyperthyroidism group) were selected. Results: for the first time, the scores of stroke scale NIHSS in hyperthyroidism group were higher than those in non-hyperthyroidism group (P 0.05) and 90 day modified Rankin scale (mRS) scores. There was no significant difference between the two groups in terms of infarct size. The proportion of hyperthyroidism group was significantly higher than that of non-hyperthyroidism group (P 0.05), hyperthyroidism group accounted for 51.2% of large area cerebral infarction, and non-hyperthyroidism group had 27.5% of large area cerebral infarction, the incidence of asymptomatic intracranial hemorrhage in hyperthyroidism group was higher than that in non-hyperthyroidism group (P 0.05). There was no significant difference in incidence of subarachnoid hemorrhage between the two groups (P 0.05). Conclusion: intravenous thrombolysis in hyperthyroidism complicated with acute cerebral infarction can benefit without increasing the incidence of symptomatic intracranial hemorrhage and subarachnoid hemorrhage.
【作者单位】：石河子大学医学院第一附属医院神经内科;中铁一局集团华县中心医院神经外科;
【基金】：国家自然科学基金资助课题(81160368)
【分类号】：R743.33;R581.1

【参考文献】