急性脑梗死患者脑白质疏松程度与静脉溶栓治疗后日常生活能力恢复的关系  

Relationship Between the Degree of Leukoaraiosis and the Recovery of Daily Living After Intravenous Thrombolytic Therapy in Patients with Acute Cerebral Infarction

作　　者：康静[1] 李晨曦[1] 范百亚 强彩芹 高焱[1] 

机构地区：[1]陕西省延安市人民医院,延安716000

出　　处：《血栓与止血学》2017年第4期591-594,598,共5页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨急性脑梗死(ACI)患者脑白质疏松(LA)程度与静脉溶栓治疗后日常生活能力恢复的关系。方法选取2013年8月至2016年2月在我院接受静脉溶栓治疗的ACI伴LA患者135例,根据Wahlund改良LA分级量表(ARWMC)评分对脑白质疏松程度进行分组,分为轻度组(n=49)、中度组(n=34)、重度组(n=52),三组患者均采用静脉溶栓治疗。于溶栓治疗后3个月采用Barthel指数评价三组患者日常生活能力恢复情况。结果三组患者溶栓治疗后3个月Barthel指数比较,差异具有统计学意义(P<0.05);Pearson相关性分析结果显示,ACI患者ARWMC评分与静脉溶栓治疗后3个月Barthel指数呈负相关(r=0.452,P<0.05);多因素Logistic回归分析结果显示,重度LA是溶栓治疗后日常生活生活功能恢复不良的独立危险因素(OR=3.952,95%CI 1.586-6.443,P=0.001)。结论 ACI患者LA及其严重程度与静脉溶栓治疗后日常生活能力恢复情况密切相关,了解LA程度对判断患者预后具有临床意义。Objective To investigate the relationship between the degree of leukoaraiosis （LA） and the recovery of daily living after intravenous thrombolytic therapy in patients with acute cerebral infarction（ACI）. Methods 135 cases of patients with ACI and LA who received intravenous thrombolytic therapy in our hospital from August 2013 to February 2016 were enrolled and divided into Mild group （ n = 49 ）, Moderate group（n--34）, Severe group（ n = 52）according to the Wahlund Modified LA Rating Scale（ ARWMC）, patients on the three groups received intravenous thrombolytic therapy. The recovery of daily living among the three groups at three months after intravenous thrombolytic therapy were evaluated by Barthel index. Results Three months after thrombolytic therapy, there was statistically significant difference on the Barthel index between the three groups （ P 〈 0.05 ） ; The Pearson correlation analysis showed that the ARWMC score was negatively correlated with the Barthel index at three months after thrombolytic therapy for patents with acute cerebral infarction（ r = 0. 452, P 〈 0.05 ） ;Multivariate logistic regression analysis showed that severe LA was an independent risk factor for poor recovery of daily living after thrombolytie therapy for patents with ACI（ OR = 3. 952,95% CI 1. 586-6. 443 ,P = 0. 001 ）. Conclusion The severity of LA in patients with ACI is closely related to the recovery of daily living capacity after intravenous thrombolytic therapy, to understand the degree of LA has a clinical significance in judging the prognosis of patients.

关 键 词：急性脑梗死 脑白质疏松 静脉溶栓 日常生活能力 LOGISTIC模型 

分 类 号：R743[医药卫生—神经病学与精神病学]