尿激酶静脉溶栓治疗急性缺血性卒中/短暂性脑缺血发作的院内死亡率及相关影响因素的多中心分析  

Inhospital Mortality and Related Influencing Factors in Acute Ischemic Stroke Patients Treated with Urokinase Intravenous Thrombolysis

作　　者：刘凯[1] 王伊龙[2] 李子孝[2] 张心邈 高远[1] 何明峰 郭学芳 赵艳艳 韩新生 赵明枝 岳建华 张平[9] 赵建华 闫红光[11] 毛向莹 刘金峰 徐雅芳[1] 陶永丽[1] 王拥军[2] 许予明[1] 宋波[1] LIU Kai;WANG Yi-Long;LI Zi-Xiao;ZHANG Xin-Miao;GAO Yuan;HE Ming-Feng;GUO Xue-Fang;ZHAO Yan-Yan;HAN Xin-Sheng;ZHAO Ming-Zhi;YUE Jian-Hua;ZHANG Ping;ZHAO Jian-Hua;YAN Hong-Guang;MAO Xiang-Ying;LIU Jin-Feng;XU Ya-Fang;TAO Yong-Li;WANG Yong-Jun;XU Yu-Ming;SONG Bo(Department of Neurology,The First Affiliated Hospital of Zhengzhou University,Henan Key Laboratory of Cerebrovascular Disease,Zhengzhou 450000,China;Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,China National Clinical Research Center for Neurological Diseases,Beijing 100070,China;Department of Neurology,Army 83th Group Hospital,Xinxiang 453000,China;Department of Neurology,People's Hospital of Huixian,Xinxiang 453000,China;Department of Neurology,People's Hospital of Yanshi,Luoyang 471000,China;Department of Neurology,Kaifeng Central Hospital,Kaifeng 475000,China;Department of Neurology,People's Hospital of Zhongmou,Zhengzhou 450000,China;Department of Neurology,Xinmi Zhongkang Hospital,Zhengzhou 450000,China;Department of Neurology,The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;Department of Neurology,Xinxiang Central Hospital,Xinxiang 453000,China;Department of Neurology,People's Hospital of Xinxiang County,Xinxiang 453000,China;Department of Neurology,People's Hospital of Changyuan County,Xinxiang 453000,China;Department of Neurology,People's Hospital of Zhenping County,Nanyang 573000,China)

机构地区：[1]郑州大学第一附属医院神经内科,河南省脑血管病重点实验室,郑州450000 [2]首都医科大学附属北京天坛医院神经病学中心,国家神经系统疾病临床医学研究中心 [3]陆军第83集团军医院神经内科 [4]辉县人民医院神经内科 [5]偃师市人民医院神经内科 [6]开封市中心医院神经内科 [7]中牟县人民医院神经内科 [8]新密市中康医院神经内科 [9]新乡医学院第一附属医院神经内科 [10]新乡市中心医院神经内科 [11]新乡县人民医院神经内科 [12]长垣县人民医院神经内科 [13]镇平县人民医院神经内科

出　　处：《中国卒中杂志》2020年第10期1078-1082,共5页Chinese Journal of Stroke

摘　　要：目的探讨尿激酶静脉溶栓治疗急性缺血性卒中/TIA患者的院内死亡率及其影响因素。方法回顾性分析2013年1月-2016年5月河南省11家市级、县级医院神经内科连续收治的发病6 h内接受尿激酶静脉溶栓治疗的急性缺血性卒中和TIA患者的临床资料,统计院内全因死亡率,采用多因素Logistic回归分析院内死亡的相关影响因素。结果共入组444例患者,平均年龄60.19±11.61岁,男性296例(66.7%),院内死亡25例(5.6%)。多因素Logistic回归分析显示,发病至溶栓时间3~6 h(OR 3.006,95%CI 1.120~8.071,P=0.029)、溶栓前NI HSS评分(OR 1.130,95%CI 1.079~1.183,P<0.001)及心房颤动病史(OR 3.671,95%CI 1.282~10.511,P=0.015)是尿激酶静脉溶栓治疗急性缺血性卒中/TIA患者院内死亡的独立影响因素。结论发病至溶栓时间3~6 h、严重神经功能损害、心房颤动病史是尿激酶静脉溶栓治疗急性缺血性卒中/TIA患者住院期间死亡的独立危险因素。Objective To investigate the inhospital mortality and related risk factors in patients with acute ischemic stroke(AIS)or TIA who received urokinase intravenous thrombolysis.Methods The data of AIS and TIA patients who received urokinase intravenous thrombolysis treatment within 6 hours after onset from 11 hospitals in Henan province were retrospectively analyzed.Baseline data and inhospital mortality were collected.Multivariate logistic regression analysis was used to identify the independent risk factors for inhospital death.Results A total of 444 patients were included,with a mean age of 60.19±11.61 years old and 296 males(66.7%).There were 25(5.6%)inhospital deaths.Multivariate analysis showed that thrombolysis in the 3-6 hour time window(OR 3.006,95%CI 1.120-8.071,P=0.029),NIHSS score at admission(OR 1.130,95%CI 1.079-1.183,P<0.001),atrial fibrillation(OR 3.671,95%CI 1.282-10.511,P=0.015),were independent risk factors for inhospital death after urokinase thrombolysis.Conclusions Intravenous thrombolysis in the 3-6 hour time window,NIHSS score at admission,atrial fibrillation were independent risk factor for inhospital death after urokinase intravenous thrombolysis in AIS/TIA patients.

关 键 词：尿激酶 缺血性卒中 死亡率 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]