轻型卒中及TIA患者静脉溶栓后短期不良结局的危险因素研究  

Analysis of risk factors in the short-term poor outcome of patients with mild stroke and TIA after intravenous thrombolysis

作　　者：陆叶婷 袁霞[1] LU Ye-ting;YUAN Xia(Department of Neurology,the First Affiliated Hospital of Soochow Uniuersitfy,215006 Suzhou,China)

机构地区：[1]苏州大学附属第一医院神经内科,215006

出　　处：《临床神经病学杂志》2021年第6期417-421,共5页Journal of Clinical Neurology

摘　　要：目的探讨轻型卒中或TIA患者静脉溶栓后短期不良结局的危险因素。方法纳入自2019年10月至2020年7月就诊于苏州大学附属第一医院予以静脉溶栓的基线NIHSS评分0~5分的轻型卒中或TIA患者94例,将其按发病14 d mRS评分分为不良结局组(mRS>1分)28例和良好结局组(mRS≤1分)66例,对基线指标以及危险因素进行单因素和多因素分析。结果年龄(OR=1.049,95%CI:1.003~1.096,P=0.035)、无责任大血管狭窄也无错配区(OR=2.808,95%CI:1.051~7.504,P=0.040)为溶栓后不良结局的独立危险因素。在CTA-Mismatch-亚组中,存在基线运动功能缺损(基线NIHSS评分中肌力评分≥1分)是患者预后不良的预测因子(P=0.004)。结论对基线NIHSS评分0~5分的患者进行溶栓决策时应将临床症状与多模式CT结合,对CTA-Mismatch-患者溶栓需谨慎。Objective To find the risk factors predicting short-term poor outcomes of mild stroke or TIA patients after intravenous thrombolysis.Methods Ninety-four mild stroke or TIA patients after intravenous thrombolysis with baseline NIHSS score of 0-5 were enrolled in the First Affiliated Hospital of Soochow University from October 2019 to July 2020.According mRS scores at 14 d after onset,patients were divided into poor outcome group(mRS>1,n=28)and good outcome group(mRS≤1,n=66).The baseline index and risk factors were analyzed by univariate and multivariate analysis.Results Age(OR=1.049,95%CI:1.003-1.096,P=0.035),CTA-Mismatch-(OR=2.808,95%CI:1.051-7.504,P=0.040)were independent risk factors for the adverse outcome of thrombolytic therapy.In the CTA-Mismatch-subgroup,the baseline motor dysfunction symptom(strength item of baseline NIHSS≥1 point)was a predictor of poor outcome(P=0.004).Conclusion When making thrombolytic decision,we should pay attention to both clinical symptoms and multi-mode CT and be careful to treat patients with CTA-Mismatch-.

关 键 词：轻型卒中 运动功能缺损 静脉溶栓 短期预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]