Dragon评分对急性缺血性卒中静脉溶栓近期疗效的预测价值  

Role of Dragon score in predicting short-term prognosis after intravenous recombinant tissue plasminogen activator therapy

作　　者：严兴亚[1] 陈然[1] 吕鸿燕[1] 李凤[1] 张勇[1] 谭守文[1] 

机构地区：[1]安徽医科大学附属六安医院神经内科三病区,安徽六安237005

出　　处：《中风与神经疾病杂志》2016年第12期1118-1121,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的：探究急性缺血性卒中患者静脉溶栓前基于Dragon评分对患者14 d结局的预测作用。方法回顾性分析60例接受静脉溶栓[阿替普酶（ r-tPA）]的急性脑梗死患者，依据溶栓前的Dragon评分将患者分为3组：A组（评分小于等于3分）、B组（评分等于4分）和C组（评分大于等于5分），比较3组患者的近期（14 d）预后。依据14 d的临床疗效分为优效组和非优效组，采用Logistic回归模型分析Dragon评分对患者14 d结局的预测作用。结果 A组优效率为65．2％、B组为优效率66．7％、C组优效率27．3％，经χ2检验，A、B之间差异无统计学意义（P＞0．05），A、C组和B、C组之间差异有统计学意义（P＜0．05），且C组的治愈和显效病例评分为5分、6分和7分的例均无好的结局。溶栓后14 d 3组颅内出血转化之间差异无统计学意义（P＝1．000）。二元Logistic回归分析显示Dragon评分与缺血性卒中溶栓患者的优效率有相关性（OR＝0．566，95％Cl 0．356～0．900，P＝0．016）。结论溶栓前Dragon评分小于5分的急性缺血性卒中患者，具有更加良好的近期（14 d）预后。Objective To evaluate the Dragon score in predicting the prognosis of acute ischemic stroke （ AIS） pa-tients with intravenous （IV） recombinant tissue plasminogen activator （rt-PA） at 14 days.Methods The data of all 60 patients who had received intravenous thrombolytic therapy were retrospectively analyzed .Patients were classified into 3 groups based on the Dragon score：group A （score≤3）,group B（score=4）and group C（score≥5）.Short-term prognosis of thrombolysis were compared among 3 groups.Patients were classified into 2 groups based on the excellent efficiency or non-excellent efficiency at day 14 after thrombolysis .The correlation between Dragon score and Short-term prognosis of thrombolysis was analyzed by logistic regression analysis .Results Excellent efficiency of A group was 65.2%,B group was 66.7%,C group was 27.3%.No difference was found between A and B groups （P〉0.05）.But the excellent efficiency of group A was significantly higher than that of group C , and group B was significantly higher than that of group C （ P〈0.05）.In addition,Patients in less than 5 points of Dragon scores were significantly higher than that of 6 points and 7 points,in group C.14 days after thrombolysis therapy .The intracranial hemorrhage rate of 3 groups were no statistically sig-nificant differences （P=1.000）.Logistic regression analysis revealed that Dragon score was significantly associated with fa -vorable prognosis at day 14 after thrombolysis （OR=0.566,95%Cl 0.356 ～0.900,P=0.016）.Conclusion Before thrombolysis therapy ,patients in less than 5 points of Dragon scores have a favorable prognosis at day 14 .

关 键 词：Dragon评分 急性缺血性卒中 阿替普酶(r-tPA) 静脉溶栓 短期预后 优效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]