Logistic回归分析124例急性缺血性脑卒中静脉溶栓后发生早期神经功能恶化的相关危险因素  

A logistic regression analysis of related risk factors of early neurological deterioration after intravenous thrombolysis in 124 patients with acute ischemic stroke

作　　者：孙青 张彬[2] SUN Qing

机构地区：[1]山东中医药大学,山东济南250000 [2]淄博市中医医院,山东淄博255300

出　　处：《中医临床研究》2022年第31期37-41,共5页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技项目(2021Z027)。

摘　　要：目的:探讨急性缺血性脑卒中静脉溶栓后发生早期神经功能恶化(Early neurological Deterioration,END)的危险因素。方法:回顾性分析2019年9月-2020年12月淄博市中医医院脑病科收治的124例发病6 h内使用尿激酶进行静脉溶栓的急性缺血性脑卒中患者的临床资料,根据溶栓后是否出现早期神经功能恶化的表现将其分为早期神经功能恶化组(19例)和非早期神经功能恶化组(105例),应用多因素Logistic回归分析溶栓后早期神经功能恶化的危险因素。结果:(1)两组患者在性别、年龄、糖尿病、高血压病、冠状动脉粥样硬化性心脏病(简称冠心病)、心房颤动、缺血性卒中史、吸烟、饮酒方面的差异无统计学意义(P>0.05)。(2)两组患者入院时血压、溶栓前美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、随机血糖、血小板计数(Platelet,PLT)、低密度脂蛋白(Low Density Lipoprotein,LDL)、高密度脂蛋白(High Density Lipoprotein,HDL)、总胆固醇(Total Cholesterol,TC)、三酰甘油(Triglyceride,TG)、同型半胱氨酸(Homocysteine,Hcy)、凝血酶原时间(Prothrombin Time,PT)、凝血酶时间(Thrombin Time,TT)、国际标准化比值(International Normalized Ratio,INR)、纤维蛋白原(Fibrinogen,FIB)、D-二聚体(D-dimer,D-D)、尿酸(Uric Acid,UA)、白蛋白(Albumin,ALB)、谷丙转氨酶(Alanine Aminotransferase,ALT)、谷草转氨酶(Aspartate Aminotransferase,AST)的差异无统计学意义(P>0.05)。(3)两组近端血管狭窄/闭塞、梗死部位(前循环梗死、后循环梗死、前循环+后循环梗死)的差异无统计学意义(P>0.05)。(4)早期神经功能恶化组的白细胞计数(White Blood Cell,WBC)、中性粒细胞数(Neutrophil,NE)、大动脉粥样硬化水平明显高于非恶化组,其差异有统计学意义(P<0.05)。(5)急性缺血性脑卒中各证型之间的差异无统计学意义(P>0.05)。(6)多因素Logistic回归分析显示,WBC、NE是尿激酶溶栓后发Objective:To investigate the risk factors of early neurological deterioration(END)after intravenous thrombolysis in acute ischemic stroke patienes.Methods:A retrospective analysis was performed on the clinical data of 124 patients with acute ischemic stroke who received intravenous thrombolysis with urokinase within 6 h of onset from September 2019 to December 2020 in the Department of Encephalopathy,Zibo Hospital of Traditional Chinese Medicine.The included cases were divided into the END group(19 cases)and the non-END group(105 cases).The risk factors of END after thrombolysis were analyzed by multivariate logistic regression.Results:(1)There were no significant differences in gender,age,diabetes,hypertension,coronary heart disease,atrial fibrillation,history of ischemic stroke,smoking and alcohol consumption between the two groups(P>0.05).(2)The differences in blood pressure on admission,NIHSS score before thrombolysi,random blood glucose,blood platelet count(PLT),low density lipoprotein(LDL),high-density lipoprotein(HDL),total cholesterol(TC),triglyceride(TG)and homocysteine(Hcy),prothrombin time(PT),thrombin time(TT),international normalized ratio(INR),fibrinogen(FIB),D-dimer(D-D),uric acid(UA),albumin(ALB),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)between the two groups were not statistically significant(P>0.05).(3)There were no significant differences in proximal vascular stenosis/occlusion,anterior circulation infarction,posterior circulation infarction,anterior circulation plus posterior circulation infarction between the two groups(P>0.05).(4)The white blood cell(WBC)count,neutrophil(NE)count and aorta atherosclerosis in the END group were significantly higher than those in the non-worsening group,and the differences were statistically significant(P<0.05).(5)There was no statistically significant difference among syndrome types of acute ischemic stroke(P>0.05).(6)Multivariate logistic regression analysis showed that WBC count and NE count were independent risk factors for early fun

关 键 词：急性缺血性脑卒中 静脉溶栓 尿激酶 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]