伴有大脑中动脉高密度征的急性脑梗死静脉溶栓早期疗效影响因素分析  

Analysis of influencing factors of early therapeutic effect of intravenous thrombolysis in patients with acute cerebral infarction accompanied by high density sign of middle cerebral artery

作　　者：黄平 邵培宁 瞿启飞 秦荣荣 蔡国栋 王莹 刘晓梅 HUANG Ping;SHAO Peining;QU Qifei;QIN Rongrong;CAI Guodong;WANG Ying;LIU Xiaomei(Department of Neurology,Tongzhou People's Hospital,Jiangsu Province,Nantong 226300,China)

机构地区：[1]江苏省南通市通州区人民医院神经内科,江苏南通226300

出　　处：《中国当代医药》2023年第22期19-23,共5页China Modern Medicine

基　　金：江苏省南通市通州区科技计划项目。

摘　　要：目的探讨伴有大脑中动脉高密度征(HMCAS)的急性脑梗死静脉溶栓早期疗效的影响因素。方法选取2020年1月至2022年9月在南通市通州区人民医院诊治的伴HMCAS的急性脑梗死患者75例为研究对象。根据溶栓后的早期疗效将其分为有效组及无效组。对两组早期疗效的影响因素进行单因素分析初筛,再将有差异的指标纳入多因素logistic回归分析,分析伴有HMCAS急性脑梗死溶栓疗效的独立影响因素。结果经溶栓治疗后,有效组47例,无效组28例。单因素分析显示,两组的年龄、糖尿病史、血糖、入院时美国国立卫生研究院卒中量表(NIHSS)评分、D-二聚体、HMCAS区CT值、Alberta卒中项目早期CT评分(ASPECTS)中的六分量表评分、合并出血情况比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,CT值(OR=0.803,95%CI:0.670~0.963)和ASPECTS六分量表评分(OR=33.328,95%CI:4.080~280.749)是影响伴有HMCAS急性脑梗死溶栓疗效的独立危险因素。结论伴HMCAS的急性脑梗死患者发病初的大脑中动脉区CT值和ASPECTS六分量表评分是影响早期溶栓疗效的独立危险因素,这两项指标可帮助临床医师对该类患者的预后进行预判,从而给出最合理的个体化治疗方案,以期患者最大获益。Objective To investigate the factors influencing the early therapeutic effect of intravenous thrombolysis in acute cerebral infarction with middle cerebral artery density sign(HMCAS).Methods A total of 75 patients with acute cerebral infarction with middle cerebral artery density were selected from Tongzhou People's Hospital in Nantong City from January 2020 to September 2022 as research subjects.According to the early therapeutic effect after thrombolytic therapy,they were divided into effective group and ineffective group.The factors affecting the early curative effect of the two groups were ini-tially screened for univariate analysis,and then the different indicators were included in the multivariate logistic regression analysis to analyze the independent factors affecting the therapeutic effect of thrombolysis in acute cerebral infarction ac-companied by HMCAS.Results After thrombolysis,there were 47 cases in effective group and 28 cases in ineffective group.Univariate analysis showed that age,diabetes history,blood glucose,National Institutes of Health stroke scale(NIHSS)score at hospital admission,D-dimer,CT value of HMCAS area,six-scale score of Alberta stroke program early CT score(AS-PECTS),and combined bleeding were compared between the two groups,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that CT value(OR=0.803,95%CI:0.670-0.963)and ASPECTS six-component score(OR=33.328,95%CI:4.080-280.749)were independent risk factors for thrombolysis in acute cerebral infarction with HMCAS.Conclusion The CT value of the middle cerebral artery area at the beginning of the onset of acute cerebral infarction patients with HMCAS and the score of the six ASPECTS scale are independent risk factors affecting the early thrombolytic efficacy.These two indicators can help clinicians predict the prognosis of these patients,so as to provide the most reasonable individual treatment plan,so as to maximize the benefit of patients.

关 键 词：大脑中动脉高密度征 急性脑梗死 静脉溶栓 早期疗效 

分 类 号：R743[医药卫生—神经病学与精神病学]