急性脑梗死患者行重组组织型纤溶酶原激活剂静脉溶栓后预后不良发生情况及其危险因素分析  

Analysis of the Occurrence and Risk Factors of Poor Prognosis after Intravenous Thrombolysis with Recombinant Tissue-Type Plasminogen Activator in Patients with Acute Cerebral Infarction

作　　者：丰喆 FENG Zhe(Department of Neurology,Qufu City People's Hospital,Qufu 273100,China)

机构地区：[1]曲阜市人民医院神经内科,山东曲阜273100

出　　处：《反射疗法与康复医学》2024年第23期103-106,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的分析急性脑梗死(ACI)患者行重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后预后不良发生情况及其危险因素。方法回顾性分析2022年1月—2023年4月曲阜市人民医院收治的105例ACI患者的临床资料,根据预后不良发生情况将其分为预后不良组、非预后不良组。收集患者一般资料,并进行单因素分析与多因素Logistic回归分析以明确急性脑梗死患者行rt-PA静脉溶栓后预后不良的危险因素。结果105例ACI患者中,有30例患者改良Rankin量表评分为3~6分,预后不良发生率为28.57%。单因素分析结果显示,两组糖尿病史、入院时美国国立卫生研究院卒中量表(NIHSS)评分、既往卒中相关性肺炎(SAP)史、中枢神经特异性蛋白(S100)水平、发病至溶栓时间比较,组间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,有糖尿病史、入院时NIHSS评分≥10分、有既往SAP史、S100水平≥0.5μg/L、发病至溶栓时间≥3 h是影响ACI患者行rt-PA静脉溶栓后预后不良发生的独立危险因素(P<0.05且OR>1)。结论ACI患者行rt-PA静脉溶栓后受有糖尿病史、入院时NIHSS评分≥10分、有既往SAP史、S100水平≥0.5μg/L、发病至溶栓时间≥3 h影响,容易发生预后不良。Objective To analyze the occurrence of poor prognosis and its risk factors after intravenous thrombolysis with recombinant tissue-type plasminogen activator(rt-PA)in patients with acute cerebral infarction(ACI).Methods A retrospective analysis was conducted on the clinical data of 105 ACI patients admitted to Qufu City People's Hospital from January 2022 to April 2023.According to the occurrence of poor prognosis,they were divided into a poor prognosis group and a non-poor prognosis group.The general information of the patients was collected,and univariate analysis and multivariate Logistic regression analysis were carried out to identify the risk factors for poor prognosis after intravenous thrombolysis with rt-PA in patients with ACI.Results Among the 105 patients with ACI,30 patients had a modified Rankin Scale score ranging from 3 to 6 points,and the incidence of poor prognosis was 28.57%.The results of univariate analysis showed that when comparing the history of diabetes,the National Institutes of Health Stroke Scale(NIHSS)score upon admission,the history of previous stroke associated pneumonia(SAP),the level of central nervous system-specific protein(S100),and the time from onset to thrombolysis between the two groups,and the differences between the groups were statistically significant(P<0.05).Multivariate Logistic regression analysis demonstrated that a history of diabetes,an NIHSS score of≥10 at admission,a history of previous SAP,an S100 level of≥0.5μg/L,and a time from onset to thrombolysis of≥3 hours were independent risk factors affecting the occurrence of poor prognosis after rt-PA intravenous thrombolysis in patients with ACI(P<0.05 and OR>1).Conclusion Patients with ACI who undergo rt-PA intravenous thrombolysis are likely to have a poor prognosis under the influence of having a history of diabetes,an NIHSS score of≥10 at admission,a history of previous SAP,an S100 level of≥0.5μg/L,and a time from onset to thrombolysis of≥3 hours.

关 键 词：急性脑梗死 重组组织型纤溶酶原激活剂 静脉溶栓 预后不良 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]