急性脑梗死患者发生早期神经功能恶化的logistic回归分析  

Logistic regression analysis of early neurological deterioration in patients with acute cerebral infarction

作　　者：王晓静[1] 卢波[1] 何妮娜[1] 吕志坤[1] 李国珍[1] 赵传清 沈丹萍 WANG Xiaojing;LU Bo;HE Ni’na;LYU Zhikun;LI Guozhen;ZHAO Chuanqing;SHEN Danping(The Second Department of Neurology,Baoding Second Central Hospital,Hebei Province,Baoding072750,China;Department of Imaging,Baoding Second Central Hospital,Hebei Province,Baoding072750,China)

机构地区：[1]河北省保定市第二中心医院神内二科,河北保定072750 [2]河北省保定市第二中心医院影像科,河北保定072750

出　　处：《中国医药导报》2021年第2期61-64,共4页China Medical Herald

基　　金：河北省医学科学研究重点课题计划项目(20171537)。

摘　　要：目的探讨急性脑梗死静脉溶栓治疗后发生早期神经功能恶化(END)的危险因素。方法选取2016年3月-2019年12月河北省保定市第二中心医院神经内科收治的152例经阿替普酶静脉溶栓治疗的急性脑梗死患者作为研究对象,根据溶栓治疗后有无呈现END的表现,分为END组(28例)和无END组(124例)。收集各研究对象的基本资料,采用单因素和多因素logistic回归分析方法分析END的危险因素。结果END组糖尿病史和缺血性卒中史比例高于无END组(P<0.05);两组梗死部位、责任血管的狭窄程度和急性卒中Org10172治疗试验(TOAST)分型比较,差异有统计学意义(P<0.05);糖尿病史、缺血性卒中史、心源性栓塞、大动脉粥样硬化均为急性脑梗死患者溶栓治疗后发生END的独立危险因素(OR=4.832、2.542、1.854、1.679,P<0.05)。结论具有糖尿病史和缺血性卒中史及TOAST分型为心源性栓塞和大动脉粥样硬化者发生END的风险更高。Objective To investigate the risk factors of early neurological deterioration(END)after intravenous thrombolysis for acute cerebral infarction.Methods A total of 152 patients with acute cerebral infarction treated by intravenous thrombolysis with Alteplase from March 2016 to December 2019 in the Department of Neurology,Baoding Second Central Hospital were selected as the research objects.According to whether the patients presented END after thrombolytic therapy,they were divided into END group(28 cases)and no-END group(124 cases).Basic data of each study object were collected,and risk factors of END were analyzed by univariate and multivariate logistic regression analysis.Results The proportions of diabetes history and ischemic stroke history in the END group were higher than those in the no-END group(P<0.05).There were significant differences in infarct site,degree of responsible vessel stenosis and trial of Org10172 in acute stroke treatment(TOAST)type between the two groups(P<0.05).Diabetes history,ischemic stroke history,cardiogenic embolism and large artery atherosclerosis were all independent risk factors of END in patients with acute cerebral infarction after thrombolytic therapy(OR=4.832,2.542,1.854,1.679,P<0.05).Conclusion People with history of diabetes and ischemic stroke,and TOAST type with cardiogenic embolism and large artery atherosclerosis are at higher risk of developing END.

关 键 词：急性脑梗死 静脉溶栓 阿替普酶 早期神经功能恶化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]