急性缺血性脑卒中静脉溶栓后主要影响神经功能改善的因素分析  

Analysis on main factors affecting neural function improvement after intravenous thrombolysis in acute ischemic stroke

作　　者：冯小鹏[1] 叶自力[1] 陈翔[1] 

机构地区：[1]广东省惠州市第一人民医院急诊内科,516003

出　　处：《检验医学与临床》2017年第17期2521-2522,2525,共3页Laboratory Medicine and Clinic

基　　金：广东省惠州市科学技术局基金资助项目(2014Y050)

摘　　要：目的探讨急性缺血性脑卒中患者在溶栓治疗后24h主要影响神经功能改善的因素。方法选择162例该院急诊内科、神经内科收治的急性缺血性脑卒中应用重组组织型纤溶酶原激活剂治疗的病程<4.5h患者,收集静脉溶栓治疗前后美国国立卫生院卒中量表评分、改良Rankin评分,以及患者的一般临床资料、危险因素、治疗时间,采用单因素分析及Logistic回归分析影响神经功能改善的因素。结果单因素分析显示,在162例患者中,36.4%的患者主要神经功能得到改善;主要神经功能得到改善很少出现在年龄≥80岁和有心房颤动的患者(P<0.05);Logistic回归分析提示,影响主要神经功能改善的独立因素为年龄≥80岁(OR=1.8,95%CI:1.5~3.2)和心房颤动(OR=2.7,95%CI:1.8~5.6)。结论急性脑卒中患者在溶栓后24h内神经系统功能的改善大多数出现在年轻及无心房纤颤的患者。Objective To investigate the main factors affecting the neural function improvement at 24 hafter intravenous thrombolysis in the patients with acute ischemic stroke.Methods One hundred and sixty-two patients with acute ischemic stroke in the departments of internal medicine emergency and neurology were selected,who received IV t-PA and had the disease course4.5h.The NIHSS score,improved Rankin score,general data,risk factors and treatment time before and after intravenous thrombolysis therapy were collected and the factors affecting the neural function improvement were analyzed by using the univariate analysis and Logistic regression analysis.Results The univariate analysis showed that among 162 cases,the main neural functions were improved in 36.4% of cases.The improvement of main neural functions rarely appeared in the patients with age≥80years old and atrial fibrillation;the Logistic regression analysis indicated that the independent factors affecting the neural function improvement were the age≥80 years old（OR=1.8,95%CI：1.5-3.2）and atrial fibrillation（OR=2.7,95%CI：1.8-5.6）.Conclusion The neural function improvement within 24 hafter thrombolysis mostly appears in the young patients and those without atrial fibrillation.

关 键 词：缺血性脑卒中 溶栓 神经功能改善 心房颤动 

分 类 号：R743.31[医药卫生—神经病学与精神病学]