王洪娟.房颤脑卒中风险评分可评估急性脑梗死患者rt-PA静脉溶栓治疗的预后[J].内科急危重症杂志,2022,28(3):196-199
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| DOI：10.11768/nkjwzzzz20220305 |
| 中文关键词: CHA2DS2-VASc评分 t-PA 急性脑卒中 预后 |
| 英文关键词: |
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| 中文摘要: |
| 目的：探讨房颤脑卒中风险（CHA-2DS-2-VASc）评分对急性脑梗死（ACI）患者rt-PA静脉溶栓预后的评估价值。方法：收集收治的108例进行rt-PA静脉溶栓的ACI患者临床资料进行回顾性分析，根据CHA2DS2-VASc评分标准，将其分为低危组（34例）、中危组（40例）及高危组（34例）；根据改良的Rankin量表（mRs）评分将其分为预后良好组（49例）及预后不良组（59例）。比较CHA2DS2-VASc评分低、中、高危组及mRs评分预后良好组、预后不良组的一般资料；观察CHA2DS2-VASc评分低、中、高危组rt-PA静脉溶栓治疗后预后情况；采用单因素分析及Logistic回归分析ACI预后的不良独立危险因素，并利用ROC 曲线分析CHA2DS2-VASc评分对ACI预后的评估价值。结果： 高危组的年龄、糖尿病、心力衰竭、卒中史的患者比例高于中危组和低危组；中危组的年龄、糖尿病、卒中史、心力衰竭的患者比例高于低危组（P均＜0.05）。预后不良组年龄、卒中史、CHA2DS2-VASc评分指标明显高于预后良好组（P均＜0.05）。高危组预后良好的患者比例少于低危组（χ2=8.589，P=0.003）；其他各组间比较，差异无统计学意义（P均＞0.05）。Logistic回归分析发现高龄、卒中史、心力衰竭、糖尿病、CHA2DS2-VASc评分为ACI预后不良独立危险因素（P均＜0.05）。CHA-2DS-2-VASc评分曲线下面积为0.803。结论：CHA2DS2-VASc评分对ACIrt-PA静脉溶栓后早期预后呈现出良好的评估价值。 |
| 英文摘要: |
| Objective: To explore the value of congestive heart failure, hypertension, age≥75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65 to 74 years, sex category (CHA2DS2-VASc) score in evaluating the prognosis of patients with acute stroke undergoing rt-PA intravenous thrombolysis. Methods: The clinical data of 108 ACI patients who received rt-PA intravenous thrombolysis were retrospectively analyzed, and they were divided into low risk group (34 cases), medium risk group (40 cases) and high risk group (34 cases) according to CHA2DS2-VASC scoring standard. According to mRs score, they were divided into good prognosis group (49 cases) and poor prognosis group (59 cases). The general data of CHA2DS2-VASc group with low, intermediate and high risk score, and modified Rankin scale (mRs) group with good prognosis and poor prognosis were compared. The prognosis of low, medium and high risk groups of CHA2DS2-VASC after intravenous thrombolytic therapy with rt-PA was observed. Single factor analysis and Logistic regression analysis were used to analyze the independent risk factors of poor ACI prognosis, the ROC curve were used to analyze the value of CHA2DS2-VASc score in evaluating the prognosis of stroke. Results: The age was older, and the proportion of patients with diabetes, heart failure and stroke history was higher in the high-risk group than those in the intermediate-risk group and the low-risk group (all P<0.05). The age was older and the proportions of patients with diabetes, stroke history, heart failure were higher in the intermediate-risk group than those in the low-risk group (all P<0.05). The age was older, the proportions of patients with stroke history and CHA2DS2-VASc score index were significantly higher in the poor prognosis group than those in the good prognosis group (P<0.05). The number of cases with good prognosis in the high-risk group was significantly less than that in the low-risk group (χ2=8.589, P=0.003); there was no significant difference among other groups (P>0.05). Logistic regression analysis found that age, stroke history, heart failure, diabetes, CHA2DS2-VASc score were all independent risk factors for poor prognosis of ACI. The area under the CHA2DS2-VASc score curve was 0.803. Conclusion: CHA2DS2-VASc score has certain value in evaluating early prognosis of acute stroke after intravenous thrombolysis with rt-PA. |
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