影响青岛地区急性缺血性卒中患者溶栓治疗的因素  

The factors influencing thrombolytic therapy in patients with ischemic stroke in Qingdao area

作　　者：王新[1] 张敏[1] 王平[1] 于谭方[1] 杜正强[1] 邢成名[1] 

机构地区：[1]青岛市市立医院东院区神经内一科,266071

出　　处：《国际脑血管病杂志》2010年第10期721-725,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的 明确青岛地区缺血性脑血管病患者的溶栓率,并分析影响溶栓治疗的原因,探讨其影响因素.方法 制定统一的青岛市卒中诊治现状调查表,回顾性连续收集2008年10月1日至2009年10月31日就诊于青岛市、县两级具有溶栓条件的11家医院神经内科的急性卒中住院患者,进行面对面问卷调查,收集其临床资料,分析影响溶栓治疗的因素.结果 实际调查缺血性脑血管病患者864例,仅10例患者接受溶栓治疗,溶栓率为1.16%,4.5 h治疗时间窗内的溶栓率为6.33%.Logistic回归分析显示,除溶栓禁忌证外,影响急性缺血性卒中患者溶栓治疗的因素还包括就诊医院级别（OR=0.061,95% Cl0.006～0.703,P=0.040）和就诊时美国国立卫生研究院卒中量表评分（OR=0.810,95%CI0.729～0.900,P=0.000）.结论 青岛地区缺血性脑血管病患者的溶栓率偏低;除溶栓禁忌证外,影响急性缺血性卒中患者溶栓治疗的因素还包括就诊医院级别和就诊时美国国立卫生研究院卒中量表评分.Objective To identify the thromolysis rate in patients with ischemic ccrebrovascular disease in Qingdao area and to analyze the causes of influcncing thrombolytic therapy and investigate their influencing factors. Methods We adopted a unified questionnaire about the status of diagnosis and treatment of stroke in Qigndao. The patients with acute stroke in the 11 departments of neurology of Qingdao municipal and county hospitals （all with thrombolytic conditios） from October 1,2008 to October 31,2009 were collected retrospectively. A face to face questionnaire survey was performed, their clinical data were collected and the factors of influencing thrombolytic therapy were analyzed. Results Actually 864 patients with ischemic eerebrovascular disease were investigated. Only 10 patients received thrombolytic therapy. The thrombolysis rate was 1.16%, and the thrombolysis rate within a 4.5-hour time widow was 6. 33 %. Logistic regression analysis showed that in addition to thrombolytic contraindications,the factors that influencing thrombolytic therapy in patients with acute ischemic stroke included the treatment in different level-hospitals （OR =0.061,95% CI O. 006-0. 703, P =0. 040） and the United States National Institutes of Health Stroke Scale （NIHSS） score （OR = 0.810,95% CI 0. 729-0.900, P = 0.000） at presentation. Conclusions The thrombolysis rate in patients with cerebrovascular disease in Qingdao area was relatively lower. In addition to thrombolytic contraindications, the factors that influencing thrombolytic therapy in ptients with acute ischemic stroke included the treatment in different level-hospitals and NIHSS score at presentation.

关 键 词：卒中 脑缺血 血栓溶解疗法 

分 类 号：R743.3[医药卫生—神经病学与精神病学]