急性脑梗死溶栓治疗近、远期疗效及影响因素分析  

Short- and long-term effects of thrombolysis in patients with acute cerebral infarction and its influencing factors

作　　者：梁志忠[1] 利玉欢[1] 李飞[1] 刘清阁[1] 潘志信[1] 

机构地区：[1]南方医科大学附属南海医院神经科,佛山528200

出　　处：《中华神经医学杂志》2012年第7期717-721,共5页Chinese Journal of Neuromedicine

基　　金：广东省医学科研基金立项课题（A2010612）;广东省佛山市科技局立项（201008114）

摘　　要：目的分析急性脑梗死溶栓治疗后近期（24h）、远期（3月后）的疗效以及相关影响因素。方法对南方医科大学附属南海医院神经科自2006年1月至2011年12月收治的53例急性脑梗死患者应用尿激酶溶栓治疗，以美国国立卫生院卒中量表评分（NIHSS）及改良的Rankin量表评分（mRS）作为评价指标，评估溶栓治疗后24h、3月后的疗效，以及对其相关影响因素进行Logistic回归分析。结果溶栓治疗后24h病情好转者有28例（52．8％1．多因素Logistic回归分析表明影响24h疗效的因素为性别（P=0．007）、发病至溶栓治疗的间隔时间（P=-0．017）及溶栓前纤维蛋白原水平（P=0．001）。溶栓治疗后3月后病情好转者有40例（75．4％），多因素Logistic回归分析表明影响3月后疗效的因素为溶栓前的NIHSS评分（P=0．002）及24h的溶栓效果（P=0．002）。结论影响急性脑梗死溶栓治疗远、近期疗效的因素不同．在临床工作中应分别注意对待。Objective To analyze the short-term （24 h） and long-term （3 months） effects of thrombolysis in patients with acute cerebral infarction and its influencing factors. Methods Fifty-three patients with acute ischemic stroke, admitted to our hospital from January 2006 to December 201 l, were treated with urokinase （UK）; the effects were observed by NIHSS and Modified Rankin Scale （mRS）. Influencing factors were analyzed by Stepwise logistic regression. Results Twenty-eight patients had good outcome （52.8%） 24 h after thrombolytic therapy; multivariate logistic regression indicated that gender, interval between onset and receiving thrombolytic therapy, and flbrinogen level before thrombolytic therapy were the independent predictors of good outcome （P=0.007, 0.017 and 0.001, respectively）. Forty patients （75.4%） had good outcome 3 months after thrombolytic therapy; multivariate logistic regression indicated that the scores of NIHSS before thrombolysis and 24-h thrombolytic effect were the independent predictors of good outcome （both P=-0.002）. Conclusion Risk factors associated with short- and long-term thrombolytic effects might be different, which needs us make a difference in clinical work.

关 键 词：脑梗死 溶栓治疗 尿激酶 近期疗效 远期疗效 影响因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]