AIS静脉溶栓后院内不良神经功能状态的混杂因素的调整和控制  

Adjustment and control of confounding factors for poor neurological status after intravenous thrombolysis in acute ischemic stroke

作　　者：刘露[1,2] 王维平[1] Liu Lu;Wang Weiping(Department of Neurology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China Corresponding author:)

机构地区：[1]河北医科大学第二医院神经内科,石家庄050000 [2]保定市第一中心医院

出　　处：《脑与神经疾病杂志》2023年第6期371-375,共5页Journal of Brain and Nervous Diseases

基　　金：河北医学科学研究课题计划(20220279)。

摘　　要：目的在调整和控制多种混杂因素后,检验变量“门-针时间”(DNT)与急性缺血性脑卒中(AIS)静脉溶栓后出现院内不良神经功能状态这一结局变量之间是否具有趋势相关性。方法收集两家卒中中心接受静脉溶栓治疗的AIS患者的基线资料及治疗资料。定义发病第7天美国国立卫生研究院卒中量表(NIHSS)评分≥16分为患者存在不良神经功能状态。在SPSS24.0中用二元Logistics回归分别代入两到多个危险因素进行调整。同样方法对变量“总缺血时间”(OTT)进行调整和控制。结果建立了三个模型分别对变量DNT和OTT的混杂因素进行调整和控制。控制了所有混杂因素后,变量DNT的OR值在各等级之间不再具有趋势性变化,趋势性P值为0.088。而变量OTT的OR值在各等级之间仍具有趋势性变化,趋势性P值为0.039。结论经调整和控制混杂因素,发现变量DNT与AIS静脉溶栓后出现院内不良神经功能状态的结局不具有趋势相关性。变量OTT与AIS静脉溶栓后出现院内不良神经功能状态的结局具有趋势相关性。Objective To adjust and control confounding factors associated with poor neurological function status after intravenous thrombolysis in Chinese patients with acute ischemic stroke(AIS).Methods Patients with AIS who received intravenous thrombolytic therapy at the two advanced Stroke Centers were included in this study,and the baseline and treatment data were collected.The National Institutes of Stroke Scale Health Stroke Scale(NIHSS)score≥16 at day 7 after onset indicated that the patients had poor neurological function status.The initial crude and adjustment models were established.In SPSS24.0,two to more risk factors were involved for adjustment using binary Logistics regression.The variable OTT was adjusted and controlled in the same way.Results Three models were established to adjust and control the confounding factors of variable DNT and OTT.After all the confounding factors of DNT were adjusted,the OR value of the three ranks had no longer trends,and the P value for trend was 0.088.After all the confounding factors of DNT were adjusted,the OR value of the three ranks still had trends,and the P value for trend was 0.039.Conclusion After adjusting and controlling confounding factors,it was found that there was no trend correlation between DNT and the poor status of neurological function after intravenous thrombolysis in acute ischemic stroke.OTT had a trend correlation with the poor status of neurological function after intravenous thrombolysis in acute ischemic stroke.

关 键 词：急性缺血性脑卒中 静脉溶栓 不良神经功能状态 混杂因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]