静脉溶栓及血管内治疗对急性脑梗死患者早期神经功能改善的分析  

Effects of intravenous thrombolysis and intra-arterial therapy on early neurological function in patients with acute ischemic stroke

作　　者：吕佳 黄显军 袁莉莉 周志明 LV- Jia;HUANG Xianjun;YUAN Lili;ZHOU Zhiming(Department of Neurology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院神经内科,安徽芜湖241001

出　　处：《皖南医学院学报》2018年第4期346-349,共4页Journal of Wannan Medical College

基　　金：国家自然科学基金项目(81171110)

摘　　要：目的:比较静脉溶栓与血管内治疗对大脑中动脉闭塞导致的急性脑梗死患者早期神经功能的改善。方法:收集2016年7~12月弋矶山医院神经内科收治的113例因大脑中动脉闭塞导致的急性脑梗死,且处于治疗时间窗内的患者。根据治疗方法分为静脉溶栓组和血管内治疗组。比较两组间基线资料并分析早期神经功能改善的影响因素。结果:113例患者中,静脉溶栓组55人(48.67%),血管内治疗组58人(51.33%)。基线资料比较显示,两组糖尿病、高血压、入院时NIHSS评分、早期神经功能改善的差异有统计学意义(P<0.05);早期神经功能改善单因素分析显示高血压病、TOAST分型、血管内治疗方式差异有统计学意义(P<0.05);多因素分析显示血管内治疗方式为脑梗死早期神经功能改善的独立保护因素(OR=4.151,95%CI:1.752~9.831,P=0.001)。结论:血管内治疗对急性脑梗死患者早期神经功能改善效果更好。Objective： To compare the effects of intravenous thrombolysis and intra-arterial therapy on early neurological improvement in patients with acute ischemic stroke in cerebral artery. Methods： The clinical data were obtained in 113 cases of acute ischemic stroke from middle cerebral artery occlusion,within the time window for treatment,admitted to and treated in our department between July and December of 2016. The cases were divided into two groups by treatment options（ either in intravenous thrombolysis or in intra-arterial therapy）. The baseline data were compared,and the factors affecting early neurological improvement were analyzed in two groups. Results： In the 113 patients,55（ 48. 67%） underwent intravenous thrombolysis and 58（ 51. 33%） intra-arterial therapy. Baseline data indicated statistical differences between group in history of diabetes and hypertension,NIHSS scoring and early neurological improvement（ P〈 0. 05）. Single factor analysis showed that history of hypertension,classification by trial of org 10172 in acute stroke treatment（ TOAST） and intra-arterial therapy were significantly different between the groups（ P〈 0. 05）. Multifactor analysis showed that intra-arterial therapy was an independent protective factor for early neurological improvement（ OR = 4. 151,95% CI： 1. 752-9. 831,P = 0. 001）. Conclusion： Intravascular therapy is superior to intravenous thrombolysis for early neurological improvement in patients with acute ischemic stroke.

关 键 词：静脉溶栓 血管内治疗 急性脑梗死 早期神经功能改善 

分 类 号：R743.3[医药卫生—神经病学与精神病学]