急性缺血性卒中患者静脉溶栓效果的影响因素分析

发布时间：2018-06-17 09:21

本文选题：卒中 + 血栓溶解疗法　；参考：《中国临床保健杂志》2016年01期

【摘要】：目的观察和分析急性缺血性卒中(AIS)患者静脉溶栓治疗的临床预后影响因素。方法选取100例行重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗的AIS患者作为研究对象,发病后90 d行改良Rankin量表(mRS)评价,并根据mRS评分将其分为预后良好组(53例)和预后不良组(47例),对两组患者的临床资料、治疗安全性及发病90 d时的病死率进行观察和比较。结果溶栓治疗后,有8例患者发生颅内出血,其中,5例为症状性颅内出血;发病后90 d,共有5例患者死亡;预后良好组患者与预后不良组患者在年龄、糖尿病史、溶栓前NIHSS评分、起病至治疗时间、溶栓前收缩压、溶栓前血糖等方面的差异均有统计学意义(t=4.727、5.126、2.715、4.249、3.918,χ2=7.868,P0.05),Logistic多元回归分析结果显示,患者溶栓治疗后出现不良预后与糖尿病史(OR=1.567)、溶栓前NIHSS评分(OR=1.916)、溶栓前收缩压(OR=1.269)、溶栓前血糖(OR=2.206)具有相关性(P0.05)。结论 AIS患者静脉溶栓治疗后的近期预后与其神经功能损害程度、糖代谢异常、血压异常等因素有关,临床医生应对这些高危因素给予准确的识别和有效的干预,以达到提高治疗效果、改善患者预后的目的。
[Abstract]:Objective to observe and analyze the prognostic factors of intravenous thrombolytic therapy in patients with acute ischemic stroke (AIS). Methods 100 AIS patients who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) were selected and evaluated with modified Rankin scale mRS90 days after onset. According to Mrs score, the patients were divided into two groups: 53 patients with good prognosis and 47 patients with poor prognosis. The clinical data, safety of treatment and mortality at 90 days were observed and compared between the two groups. Results after thrombolytic therapy, there were 8 patients with intracranial hemorrhage, 5 patients with symptomatic intracranial hemorrhage, 90 days after the onset of thrombolysis, 5 patients died. The scores of NIHSS before thrombolysis, the time from onset to treatment, the systolic blood pressure before thrombolysis and the blood sugar before thrombolytic therapy were significantly different. The poor prognosis after thrombolytic therapy was correlated with the history of diabetes, NIHSS score before thrombolytic therapy, systolic blood pressure before thrombolytic therapy and blood glucose before thrombolytic therapy (P < 0.05). Conclusion the short-term prognosis of patients with AIS after intravenous thrombolytic therapy is related to the degree of neurological damage, abnormal glucose metabolism, abnormal blood pressure and so on. Clinicians should give accurate identification and effective intervention to these high risk factors. In order to improve the therapeutic effect and improve the prognosis of patients.
【作者单位】：第三军医大学大坪医院神经内科;重庆医科大学附属第一医院老年科;
【分类号】：R743.3

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