吸烟与男性脑梗死静脉溶栓预后的相关性研究  

Correlation Analysis about Smoking and Functionanal Outcome of Intravenous Thrombolysis in Male Patient with Acute Stroke

作　　者：姚恩生[1] 唐燕[2] 张云霞[1] 张惠丽[1] 申婧[1] 田凤[1] 王宏[1] 

机构地区：[1]石河子大学医学院第一附属医院神经内科,新疆石河子832008 [2]石河子大学医学院第一附属医院老干一科,新疆石河子832008

出　　处：《农垦医学》2016年第4期289-292,共4页Journal of Nongken Medicine

基　　金：石河子大学医学院第一附属医院科研项目(YL2015-S011)

摘　　要：目的:探讨吸烟与男性脑梗死阿替普酶(recombinant tissue plasminogen activator,rt-PA)静脉溶栓预后的相关性。方法:回顾性分析105例部分前循环急性脑梗死患者,发病均在4.5h以内并进行rt-PA静脉溶栓治疗的男性患者,分为吸烟和不吸烟组。比较两组入院时和溶栓7天时神经功能缺损评分(National Institutes of Health Stroke Scale NIHSS),症状性脑出血,90天改良Rankin量表(modified Rankin Score m RS)评分。结果:入组105名男性患者,包括吸烟组45人(42.9%)和不吸烟组60人(57.1%)。两组入院时及一周后的NIHSS评分统计学未见明显差异(P=0.176)。随访3个月后,预后良好的患者(m RS=0-1)在两组之间未见明显差异(P=0.866),Logistic多因素回归分析显示,年龄轻和入院时低的NIHSS评分与良好预后明显相关,分别是年龄(OR=0.962,95%CI=0.932-0.992,P=0.014),入院时NIHSS评分(OR=1.253,95%CI=1.090-1.441,P=0.002)。吸烟与良好预后无相关性(OR=0.935,95%CI=0.431-2.029,P=0.866)。结论:男性青年和轻型卒中与溶栓后良好预后明显相关,吸烟与男性脑梗死rt-PA溶栓后良好预后无相关性。Objective： To evaluate the correlation analysis of smoking and prognosis of thrombolysis in male patients with acute stroke.Methods： In this study, 105 patients were including and retrospectively analyzed, the effects of smoking status on prognosis of male AIS patients receiving recombinant tissue plasminogen activator（t PA）treatment were investigated. Male patients with partial anterior circulation infarcts（PACI） receiving intravenous t PA within 4.5 hours were divided into smoking group, non-smoking group. Patients were scored by National Institutes of Health Stroke Scale（NIHSS） before t PA treatment and one week after the stroke. The primary outcome was modified Rankin Score（m RS） three months after stroke. Results： A total of 105 male patients were involved in this study,including 45（42.9%） smokers and 60（57.1%） non-smokers. There was no significant difference of the NIHSS score at one week after stroke（P=0.176） between the two groups. The favorable outcome（m RS 0-1） at 3 months was obtained in 46.7% of smokers versus 48.3% of non-smokers（P=0.866） and was not associated with smoking by logistic regression analysis（OR=0.935,95% CI=0.431-2.029,P=0.866）.There were associated between the age（OR=0.962,95% CI=0.932-0.992,P=0.014）, NIHSS on admission（OR=1.253,95% CI1.090-1.441,P=0.002） and favorable outcome of patients treated with t PA for ischaemic stroke. Conclusion： We found that young and small stroke associated with favorable outcome, but did not find any correlation between smoking and the favorable short-time outcome of male patients treated with t PA for ischaemic stroke.

关 键 词：脑梗死 吸烟 预后 静脉溶栓 男性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]