急性脑梗死静脉溶栓疗效的影响因素分析  

Analysis of Influencing Factors on the Efficacy of Intravenous Thrombolysis in Acute Cerebral Infarction

作　　者：王宁 秦利 孟剑 黄璜 Wang Ning;Qin Li;Meng Jian;Huang Huang(Department of Neurology,Sihong Hospital,Sihong 223900,Jiangsu Province,China)

机构地区：[1]泗洪医院神经内科,江苏泗洪223900

出　　处：《罕少疾病杂志》2023年第9期29-30,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的 分析影响急性脑梗死静脉溶栓治疗14天时疗效的相关因素。方法 回顾性分析2019年1月至2022年6月在泗洪医院接受静脉溶栓治疗的166例急性缺血性脑卒中患者的临床资料,以治疗后14天NIHSS评分变化情况及临床症状改善情况作为判定标准,将所有患者分为有效组和无效组。通过治疗前及治疗后14天NIHSS评分及症状变化情况比较静脉溶栓疗效。比较两组患者的人口学资料、缺血性卒中相关病史、溶栓相关指标、检验及影像学检查结果等临床相关资料,并应用Logistic回归分析急性脑梗死静脉溶栓治疗14天时疗效的影响因素。结果 在接受静脉溶栓治疗的166例急性脑梗死患者中,有效组138例,有效率83.1%,无效组28例,无效率16.9%。单因素分析结果显示,两组患者在心房颤动史、糖尿病史、脑梗死病史,溶栓前NIHSS评分、梗死部位(前后循环梗死)、责任大动脉狭窄、发病至溶栓时间、溶栓药物的选择、出血转化、肺部感染、血清白蛋白等方面差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,心房颤动史、溶栓前NIHSS评分、梗死部位(前后循环梗死)、发病至溶栓时间、责任大动脉狭窄、肺部感染、血清白蛋白是影响急性脑梗死静脉溶栓治疗14天疗效的独立因素(OR>1,P<0.05)。结论静脉溶栓能有效治疗急性脑梗死,但其疗效受心房颤动史、发病至溶栓时间、梗死部位(前后循环梗死)、责任大动脉狭窄、溶栓前NIHSS评分、肺部感染、血清白蛋白等因素的影响显著。Objective To analyze the related factors that affect the efficacy of intravenous thrombolytic therapy for acute cerebral infarction at 14th day.Methods The clinical data of 166 patients with acute ischemic stroke who received intravenous thrombolytic therapy in Sihong Hospital from January 2019 to June 2022 were retrospectively analyzed.Based on the changes in NI HSS scores and the improvement of clinical symptoms 14th day after treatment,all patients were divided into effective and ineffective groups.The efficacy of intravenous thrombolysis was compared by NIHSS scores and symptom changes before and 14th day after treatment.The demographic data,ischemic stroke related medical history,thrombolytic related indicators,testing,and imaging findings of the two groups of patients were compared.Logistic regression was used to analyze the influencing factors for the efficacy of intravenous thrombolytic therapy for acute cerebral infarction at 14th day.Results Among 166 patients with acute cerebral infarction who received intravenous thrombolytic therapy,138 were in the effective group,with an effective rate of 83.1%,while 28 were in the ineffective group,with an ineffective rate of 16.9%.The results of univariate analysis showed that there were statistically significant differences between the two groups in the history of atrial fibrillation,diabetes,history of cerebral infarction,NI HSS score before thrombolysis,infarction site(anterior and posterior circulation infarction),stenosis of major responsible arteries,time from onset to thrombolysis,choice of thrombolytic drugs,bleeding transformation,lung infection,serum albumin,etc.(P<0.05);Multivariate logistic regression analysis showed that the history of atrial fibrillation,NI HSS score before thrombolysis,infarct site(anterior and posterior circulation infarction),time from onset to thrombolysis,responsible artery stenosis,pulmonary infection,and serum albumin were independent factors affecting the efficacy of intravenous thrombolytic therapy for acute cerebral infarct

关 键 词：急性脑梗死 静脉溶栓 疗效 影响因素 

分 类 号：R742[医药卫生—神经病学与精神病学]