急性脑梗死溶栓后再梗死的相关因素分析  

Analysis of Related Factors of Reinfarction after Thrombolysis in Patients with Acute Cerebral Infarction

作　　者：杨正敏 杨雄杰[2] YANG Zhengmin;YANG Xiongjie(Wuhu City Hospital of Traditional Chinese Medicine Postgraduate Training Base Affiliated of Anhui University of Chinese Medicine,Anhui Wuhu 241000,China;Wuhu Traditional Chinese Medicine Hospital,Anhui Wuhu 241000,China)

机构地区：[1]安徽中医药大学(附属)芜湖市中医医院专硕研究生培养基地,安徽芜湖241000 [2]安徽省芜湖市中医医院,安徽芜湖241000

出　　处：《中医药临床杂志》2023年第1期113-117,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：安徽省中医发展专项资金项目(2021018);安徽省芜湖市科技计划项目基金(2021070)。

摘　　要：目的:通过急性脑梗死静脉溶栓后再梗死的相关因素分析,旨在发现溶栓后再梗死的高危因素,为临床干预溶栓后再梗死提供理论依据。方法:回顾性分析2016年9月-2022年2月收治的101例发病时间<4.5h、接受阿替普酶静脉溶栓的急性脑梗死患者的临床资料。静脉溶栓后神经功能缺损症状改善后再次加重或症状消失后再次出现者为再梗死组,其余患者为未再梗死组。分别采集比较2组性别、年龄、脑血管病危险因素、发病至接受溶栓时间、入院时国立卫生研究院卒中量表(NIHSS)评分、中风病临床症候评分、血脂、血糖、糖化血红蛋白、同型半胱氨酸、超敏C反应蛋白、凝血功能等指标。结果:入组患者再梗死发生率为15.84%。再梗死组年龄、入院时NIHSS评分、中风病临床症候评分、空腹血糖、D-二聚体、纤维蛋白原水平显著高于未再梗死组,差异有统计学意义。结论:年龄、NIHSS评分、中风病临床症候评分、空腹血糖、D-二聚体、纤维蛋白原等指标与静脉溶栓后再梗死存在相关性,可能为溶栓后再梗死预测因子。Objective: Through the analysis of related factors of reinfarction after intravenous thrombolysis in acute cerebral infarction, the aim is to find the high risk factors of reinfarction after thrombolysis, and to provide theoretical basis for clinical intervention of reinfarction after thrombolysis. Methods: The clinical data of 101 acute cerebral infarction patients with onset time <4.5 hours who received intravenous alteplase thrombolysis from September 2016 to February 2022 were retrospectively analyzed. After intravenous thrombolysis, the symptoms of neurological deficits aggravated after improvement or reappeared after the symptoms disappeared, were in the reinfarction group, and the rest were in the non-reinfarction group. The gender, age, risk factors of cerebrovascular disease, time from onset to thrombolysis, National Institutes of Health Stroke Scale(NIHSS) score at admission, stroke clinical symptom score, blood lipid, blood sugar, glycosylated hemoglobin, and isotype were collected and compared between the two groups. Cysteine, high-sensitivity C-reactive protein, coagulation function and other indicators. Results: The incidence of reinfarction among the enrolled patients was 15.84%. Age, NIHSS score at admission, stroke clinical symptom score, fasting blood glucose, Ddimer, and fibrinogen levels in the reinfarction group were significantly higher than those in the non-reinfarction group, and the difference was statistically significant. Conclusion: Age, NIHSS score, stroke clinical symptom score, fasting blood glucose, D-dimer, fibrinogen and other indicators are correlated with reinfarction after intravenous thrombolysis,and may be predictors of reinfarction after thrombolysis.

关 键 词：溶栓后再梗死 溶栓后再闭塞 静脉溶栓 相关因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]