老老年急性缺血性脑卒中溶栓治疗预后分析  

The prognosis of old elderly patients with acute ischemic stroke treated by intravenous thrombolysis

作　　者：张彤[1] 卢桂静[2] 

机构地区：[1]北京首都医科大学附属北京世纪坛医院 [2]中南大学湘雅医院心血管内科,410008

出　　处：《中国神经免疫学和神经病学杂志》2014年第2期120-122,共3页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的探讨影响老老年急性缺血性脑卒中溶栓患者预后的因素。方法选取北京世纪坛医院神经内科2006‐06-2012‐06间使用重组组织型纤溶酶原激活剂(rt‐pA)进行静脉溶栓治疗的急性缺血性脑卒中的老老年患者81例,收集每个患者年龄、性别、高脂血症、高血压病、糖尿病病史等基线情况及来院后的血压、血糖、血脂、血浆致动脉硬化指数(atherogenic index of plasma,AIP)、颈动脉内膜中层厚度(intima‐media thickness,IMT)等指标,采用改良Rankin量表(mRS)评估患者远期预后(发病后90d时),并分析这些指标与疗效评分(mRS评分)的关系。结果单因素分析提示发病到溶栓时间〔(138.3±11.3)min〕、溶栓前NIHSS评分〔(6.2±3.3)分〕、AIP(0.22±0.03)和颈动脉IMT〔(0.99±0.47)mm〕4个危险因素在预后良好与预后不良两组中差异有统计学意义(P<0.05)。进一步Logistic回归分析显示预后不良与AIP、颈动脉IMT正相关(分别OR=9.615,P=0.006;OR=7.623,P=0.012)。结论老老年急性脑卒中溶栓患者的预后与颈动脉IMT、AIP相关。Objective To explore the influencing factors of acute ischemic stroke thrombolysis treatment outcome in old elderly patients. Methods Eighty-one old elderly acute ischemic stroke cases treated by intravenous rt-PA in Beijing Shijitan Hospital from 2006-06 to 2012-06 were included. The patients＇ age, gender, history about hyperlipidemia, hypertension, diabetes mellitus and other conditions and baseline blood pressure, blood glucose, cholesterol, atherogenic index of plasma （ALP）, carotid intima-media thickness （IMT） and other indicators after admitted to the hospital were collected; the modified Rankin scale （mRS） scores were assessed 90 days after disease onset. We analyzed the relationship between these indexes and clinical score （mRS score）. Results Univariate analysis showed that the onset to thrombolytic time [ （138.3 ±11.3） mini, NIHSS score before thrombolysis （6.2±3.3）, AIP （0.22±0.03）, and carotid IMT [ （0.99 ± 0.47） mm） were risk factors for the prognosis （P 〈 0.05）. Logistic regression analysis revealed that AIP and carotid IMT were positively correlated with prognosis （OR= 9. 615, P=0,006 ; OR = 7. 623, P／ 0. 012）. Conclusions The old elderly patients with acute stroke thrombolysis and carotid prognosis IMT, AIP related.

关 键 词：老老年 脑卒中 溶栓治疗 颈动脉内膜中层厚度 血浆致动脉硬化指数 

分 类 号：R734.31[医药卫生—肿瘤]