侧支循环与超窗脑梗死静脉溶栓预后相关性分析  

Correlation Analysis between Collateral Circulation and Prognosis of Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Extended Therapeutic Window

作　　者：孙威[1] 于敏[1] 马舒贝[2] 孙鹭 滕秀涵[1] 杨颖[1] 赵红军[1] 张鑫 SUN Wei;YU Min;MA Shubei;SUN Lu;TENG Xiuhan;YANG Ying;ZHAO Hongjun;ZHANG Xin(Department of Neurology,Dalian Third People's Hospital,Dalian 116033,China;Department of Neurology,Dalian Central Hospital,Dalian 116033,China)

机构地区：[1]大连市第三人民医院神经内科,辽宁大连116000 [2]大连市中心医院神经内科,辽宁大连116000

出　　处：《中国医药指南》2021年第18期58-60,共3页Guide of China Medicine

摘　　要：目的探讨基础侧支循环情况与超常规时间窗(OTT>4.5 h)进行rt-PA静脉溶栓治疗脑梗死预后的相关性。方法采用回顾性研究法收集OTT>4.5 h的急性颈内动脉系统脑梗死患者且接受rt-PA静脉溶栓治疗的患者91例,根据溶栓后90 d的mRS作为评价临床结局是否良好的指标,分为结局良好组(51例)及结局不良组(40例),利用rLMC评分评估侧支循环。结果两组患者的基线NIHSS评分、rLMC评分(0~10)比较存在明显的统计学差异(P<0.05)。多因素二分类Logistic回归分析结果显示:基线NIHSS评分及rLMC评分(0~10)是影响超时间窗溶栓患者的远期预后的独立危险因素(P<0.05)。结论急性脑梗死患者的基线NIHSS及rLMC评分是静脉rt-PA溶栓后90 d预后结果的预测因子。Objective To investigate the correlation between the basic collateral circulation and the prognosis of cerebral infarction treated by rt-PA intravenous thrombolysis with OTT>4.5 hours.Methods Ninety-one patients with acute internal carotid artery system ischemic stroke with OTT>4.5 hours and received rt-PA treatment were collected retrospectively.According to the MRS score of 90 days after thrombolysis,the patients were divided into good outcome group(n=51)and poor outcome group(n=40).Results The baseline NIHSS score and rLMC score(0-10)of the two groups were significantly different(P<0.05).The results of multivariate binary logistic regression analysis showed that the baseline NIHSS score and rLMC score(0-10)were independent risk factors affecting the long-term prognosis of patients with thrombolysis over time window(P<0.05).Conclusion The baseline NIHSS and rLMC scores of patients with acute cerebral infarction are predictors of prognosis 90 days after intravenous rt-PA thrombolysis.

关 键 词：脑卒中 超时间窗 静脉溶栓 侧支循环 RT-PA 

分 类 号：R743.33[医药卫生—神经病学与精神病学]