急性脑梗死患者急诊rt-PA溶栓后发生血管再闭塞的相关因素分析  

Analysis of related factors of vascular reocclusion after emergency rt-pA thrombolysis in patients with acute cerebral infarction

作　　者：周裕文 ZHOU Yu-wen(Emergency Department,Chencun Hospital Affiliated to Shunde Hospital of Southern Medical University,Foshan 528313,China)

机构地区：[1]南方医科大学顺德医院附属陈村医院急诊科,528313

出　　处：《中国现代药物应用》2022年第20期41-44,共4页Chinese Journal of Modern Drug Application

摘　　要：目的分析急性脑梗死患者急诊重组组织型纤溶酶原激活物(rt-PA)溶栓后发生血管再闭塞的相关因素。方法回顾性分析进行急诊rt-PA溶栓治疗的125例急性脑梗死患者的临床资料,依据患者血管再闭塞情况分为再闭塞组(48例)与无再闭塞组(77例)。给予患者阿替普酶静脉注射治疗,对比患者一般资料,进行单因素分析,并采用Logistic多因素分析急性脑梗死患者急诊rt-PA溶栓后发生血管再闭塞的独立危险因素。结果再闭塞组神经功能缺损评分(15.68±3.25)分、收缩压(163.52±20.78)mm Hg(1 mm Hg=0.133 kPa)、血糖(7.68±2.12)mmol/L、发病至溶栓时间(192.21±43.21)min、糖尿病史率54.2%均高于无再闭塞组的(10.62±2.34)分、(145.62±22.58)mm Hg、(6.19±2.01)mmol/L、(146.52±32.78)min、23.4%,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,神经功能缺损评分、血糖、糖尿病、发病至溶栓时间为急性脑梗死溶栓后血管再闭塞的独立危险因素(P<0.05)。结论神经功能缺损评分、血糖、糖尿病、溶栓时间窗等是导致急性脑梗死患者急诊rt-PA溶栓后血管再闭塞的独立危险因素。因此,做好自身防范,尽早进行溶栓治疗,积极控制血糖水平可有效预防血管再闭塞的发生。Objective To analyze the related factors of vascular reocclusion after emergency recombinant tissue plasminogen activator(rt-pA)thrombolysis in patients with acute cerebral infarction.Methods The clinical data of 125 patients with acute cerebral infarction who received emergency rt-PA thrombolytic therapy were retrospectively analyzed,and they were divided into reocclusion group(48 cases)and non-reocclusion group(77 cases)according to the status of vascular reocclusion.Both groups were given alteplase intravenous injection,and the general data of the patients were compared for univariate analysis.Logistic multivariate analysis was used to analyze the independent risk factors of vascular reocclusion after emergency rt-PA thrombolysis in patients with acute cerebral infarction.Results In the reocclusion group,the neurological deficit score was(15.68±3.25)points,the systolic blood pressure was(163.52±20.78)mm Hg(1 mm Hg=0.133 kPa),the blood glucose was(7.68±2.12)mmol/L,the time from onset to thrombolysis was(192.21±43.21)min,and the rate of diabetes mellitus history was 54.2%,which were higher than(10.62±2.34)points,(145.62±22.58)mm Hg,(6.19±2.01)mmol/L,(146.52±32.78)min,and 23.4%in the non-reocclusion group,and the differences were all statistically significant(P<0.05).Multivariate Logistic regression analysis showed that neurological deficit score,blood glucose level,diabetes mellitus,time from onset to thrombolysis were independent risk factors for vascular reocclusion after thrombolysis for acute cerebral infarction(P<0.05).Conclusion Neurological deficit score,blood glucose,diabetes mellitus,thrombolytic time window are independent risk factors that lead to vascular reocclusion after emergency rt-PA thrombolysis in patients with acute cerebral infarction.Therefore,selfprevention,early thrombolytic therapy,and active control of blood glucose levels can effectively prevent the occurrence of vascular reocclusion.

关 键 词：急性脑梗死 急诊 重组组织型纤溶酶原激活物 溶栓 血管再闭塞 相关因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]