重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中伴糖尿病患者疗效观察  

Effect of diabetes mellitus on the efficacy of rt-PA intravenous thrombolysis in patients with acute ischemic stroke

作　　者：蔡若蔚[1] 黄银辉[2] 陈雅芳[1] 林友榆 卓识途 李明媚[4] 许盈盈[1] 杨美丽[1] 李隽静[3] 张碧月[1] 陈振杰[4] 

机构地区：[1]福建医科大学附属第二医院神经内科, 泉州362000 [2] 福建省晋江市医院神经内科 [3] 福建医科大学附属泉州第一医院神经内科 [4]福建省安溪铭选医院神经内科

出　　处：《中华老年医学杂志》2014年第10期1064-1067,共4页Chinese Journal of Geriatrics

摘　　要：目的 探讨糖尿病对急性缺血性脑卒中患者组织型纤溶酶原激活剂（rt-PA）静脉溶栓疗效的影响. 方法 从2009年2月到2013年2月连续收集发病4.5h内给予rt-PA溶栓的急性缺血性脑卒中患者作为研究对象.采用改良的Rankin量表（mRS）评价神经功能恢复状况,并根据Rankin量表评分分为预后良好组（mRS评分0～1分,88例）及预后不良组（mRS评分2～6分,74例）. 结果 预后良好组与预后不良组相比,有糖尿病者较少（9.09％比28.38％,P=0.001）.Logistic多因素回归分析显示糖尿病不是症状性颅内出血的危险因素（OR=0.925,95％ CI：0.075～11.362,P=0.951）,而是影响溶栓预后的因素（OR=7.132,95％ CI：I.257～40.466,P=0.027）.结论 合并糖尿病的急性缺血性脑卒中患者rt-PA静脉溶栓预后较差.Objective To explore the effect of diabetes mellitus on the efficacy of recombinant tissue plasminogen activator（rt-PA） intravenous thrombolysis in patients with acute ischemic stroke.Methods Consecutive patients with acute ischemic stroke who received intravenous rt-PA within 4.5 hours from symptom onset were included in this study during February 2009 to February 2013.Modified Rankin Scale （mRS） was used to evaluate the recovery of neurological functions.Patients were divided into good（Rankin Scale score of 0-1,n=88）or poor （Rankin Scale score of 2 6,n=74） outcome group.Results The patients with diabetes showed significantly lower rate in good outcome group versus in poor outcome group（9.09% vs.28.38%,P=0.001）.Logistic regression analysis showed that diabetes mellitus was not related to hemorrhagic transformation independently （OR=0.925,95% CI：0.075-11.362,P=0.951）,but was related to thrombolytic outcome independently （OR=7.132,95% CI：1.257-40.466,P=0.027）.Conclusions The diabetic patients with acute ischemic stroke have a worse outcome in rt-PA thrombolysis treatment.

关 键 词：糖尿病 卒中 组织型纤溶酶原激活物 

分 类 号：R743.3[医药卫生—神经病学与精神病学]