溶栓治疗急性缺血性脑卒中患者的早期神经功能恶化情况及危险因素分析  

Analysis of Early Neurological Deterioration and Risk Factors in Patients with Acute Ischemic Stroke Treated with Thrombolytic Therapy

作　　者：宋文明[1] 刘菊花[1] 黄勇[1] 林晰敏 王发 欧华群[1] SONG Wenming;LIU Juhua;HUANG Yong;LIN Ximin;WANG Fa;OU Huaqun(The People’s Hospital of Lianjiang,Lianjiang 524400,China;不详)

机构地区：[1]广东省廉江市人民医院,广东廉江524400

出　　处：《中国医学创新》2020年第15期133-136,共4页Medical Innovation of China

基　　金：湛江市科技计划项目(2019B01041)。

摘　　要：目的:探讨溶栓治疗急性缺血性脑卒中(AIS)患者的早期神经功能恶化(END)情况及危险因素。方法:回顾性分析2017年7月-2019年10月在本院神经内科住院的150例AIS患者的临床资料。统计AIS患者溶栓治疗后的END发生率、END病因及END在不同TOAST分型AIS中的分布情况。根据是否发生END将AIS患者分为END组和对照组。采用单因素和多因素Logistic回归分析END的危险因素。结果:END的发生率为23.3%(35/150)。原因未明的END占45.7%(16/35)。来源于大动脉粥样硬化型AIS的END占48.6%(17/35)。多因素Logistic回归分析显示踝肱指数≤0.9、糖尿病、大动脉粥样硬化型卒中、入院NIHSS评分>7分、无抗血小板治疗是END的独立危险因素。结论:原因未明和来源于大动脉粥样硬化型AIS的END最为常见。踝肱指数≤0.9、糖尿病、大动脉粥样硬化型卒中、入院NIHSS评分>7分、无抗血小板治疗是END的独立危险因素。Objective:To investigate the early neurological deterioration(END)and its risk factors in patients with acute ischemic stroke(AIS)treated with thrombolytic therapy.Method:The clinical data of 150 AIS patients hospitalized in the department of neurology of our hospital from July 2017 to October 2019 were retrospectively analyzed.The END incidence rate,the END etiology and the distribution of END in different TOAST classifications of AIS after thrombolytic therapy in AIS patients were calculated.AIS patients were divided into END group and control group according to whether or not END occurred.Univariate and multivariate Logistic regression was used to analyze the risk factors of END.Result:The incidence of END was 23.3%(35/150).The END with unknown reasons accounted for 45.7%(16/35).END from atherosclerotic AIS accounted for 48.6%(17/35).Multivariate Logistic regression analysis showed that ankle-brachial index≤0.9,diabetes mellitus,atherosclerosis of aorta,admission NIHSS score>7 scores,and non-antiplatelet therapy were independent risk factors for END.Conclusion:The causes unknown and END from atherosclerotic AIS is the most common.Ankle-brachial index≤0.9,diabetes mellitus,atherosclerosis of aorta,admission NIHSS score>7 scores,and non-antiplatelet therapy are independent risk factors for END.

关 键 词：溶栓治疗 急性缺血性脑卒中 早期神经功能恶化 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]