吴辉,陈晓光,王帆.静脉溶栓患者疗效与预后因素分析[J].内科急危重症杂志,2017,23(5):
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| DOI： |
| 中文关键词: 急性脑梗死 静脉溶栓 临床疗效 影响因素 |
| 英文关键词:Stroke Intravenous thrombolysis Clinical efficacy Influence factors |
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| 中文摘要: |
| 目的：分析武汉市第一医院神经内科接受静脉溶栓的急性脑梗死患者的临床疗效并探讨或可影响疗效的相关因素。方法：统计 2012年4月至2015年12月武汉市第一医院神经内科接受重组人组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗的138例急性脑梗死患者的一般资料，并分析预后良好率和预后不良率来判断临床疗效。 Logistic 多因素分析90天预后良好相关影响因素。结果：连续纳入 138例急性缺血性卒中患者，结局良好比例为 58.7 ％ (81／138 )，单因素分析显示：患者年龄(U =1761．00 ，P = 0．018) 、入院时美国国立卫生研究院卒中量表(NIHSS)评分(U = 657.00，P < 0．01)、24 h NIHSS评分 (U = 427．00，P < 0．01) 及早期症状 改善 (24 h NIHSS 评分降低 ≥4 分或者降至 0 分；X2 =37.3，P <0．01)是影响临床结局的因素。80 岁以上老年脑梗死患者溶栓早期NIHSS评分改善较80岁以下的患者无明显差异。结论：我院急性脑梗死患者 rt-PA 静脉溶栓有较好疗效。基线 NIHSS 评分和早期症状改善为静脉溶栓3个月结局的独立预测因素。 |
| 英文摘要: |
| Abjective To determine factors associated with favorable clinical outcome in acute ischemic stroke patients who received in The First Hospital of WuHan．Methods Patients treated with intravenous recombinant tissue plasminogen activator (rt．PA ) between April 1，2012 and December 31，2015 were recruited．Favorable outcome was defined as modified Rankin scale (mRS ) score < 2 at 3 months．The baseline characteristics were compared by univariate and multivariate analysis. Results Of all the 138 patients studied，the rate of patients with a favorable outcome was 58.7(81/138).Univariate analysis showed that age (U =1761．00 ，P = 0．018)，admission NIHSS score (U = 657.00，P < 0．01),24 h NIHSS score (U = 427．00，P < 0．01)，and early symptom improvement (24．hour N IH SS score decreased ≥ 4 points，or down to 0 point；Y = 19．576 ，P < 0．01) were the factors associated with clinical outcomes． Multivariate analysis revealed that baseline NIH SS score and early symptom improvement were independent predictors of clinical outcomes． Over the age of 80 elderly patients with cerebral infarction early thrombolysis NIHSS score improvement is no difference between the patients under the age of 80. Conclusions The effect of intravenous thrombolysis 0n clinical outcomes of acute ischemic stroke patients is baseline NIHSS score ，and early symptom improvement are independent predictors of clinical outcomes after intravenous thrombolysis． |
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