丁苯酞联合阿替普酶治疗缺血性ACI的近期疗效及其预后影响因素Logistic回归分析  

Short-term efficacy of butylphthalide combined with alteplase in the treatment of ischemic ACI and its prognostic influencing factors by logistic regression analysis

作　　者：张岳 ZHANG Yue(Department of Neurology,Quanzhou First Hospital,Fujian Province,Quanzhou 362000,China)

机构地区：[1]福建省泉州市第一医院神经内科,362000

出　　处：《临床合理用药》2025年第9期22-26,共5页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察丁苯酞联合阿替普酶治疗缺血性急性脑梗死(ACI)的近期疗效及其预后影响因素Logistic回归分析。方法回顾性选取2020年2月—2023年2月泉州市第一医院收治的缺血性ACI患者153例为研究对象,均采用丁苯酞与重组组织型纤溶酶原激活剂(rt-PA)——阿替普酶联合治疗,根据改良Ranking量表(mRS)评估患者预后情况,将其分为预后良好组(n=122)、预后不良组(n=31)。采用美国国立卫生研究院卒中量表(NIHSS)评估治疗效果,收集性别、年龄、吸烟史、发病至就诊时间、心房颤动、家庭居住地、NIHSS评分、婚姻情况、文化程度、白细胞计数、糖尿病史资料,采用Logistic回归分析影响缺血性ACI患者治疗后出现预后不良情况的因素。结果纳入153例缺血性ACI患者,治疗总有效率为90.85%(139/153),根据随访mRs填表结果,其中预后良好组122例,预后不良组31例。预后良好组在年龄、发病至就诊时间、心房颤动、NIHSS评分、白细胞计数以及是否有糖尿病史与预后不良组差异有统计学意义(P<0.01),多因素Logistic回归分析结果表明,年龄≥60岁、发病至就诊时间≥180 min、有心房颤动、NIHSS评分≥15分、白细胞计数异常、有糖尿病史是影响接受治疗后缺血性ACI患者预后不良的危险因素(P<0.05或P<0.01)。结论缺血性ACI患者采用丁苯酞联合阿替普酶进行治疗能够有效帮助患者恢复脑组织供血,整体治疗效果较好。但仍有部分患者在接受治疗后出现预后不良情况,导致预后不良的因素较多,包含年龄、发病至就诊时间、心房颤动、NIHSS评分、白细胞计数以及是否有糖尿病史等,故临床医师在对患者进行治疗时应及时对上述因素进行重点关注,根据患者实际情况制定针对性方案,降低患者出现不良预后的风险。Objective To observe the short-term efficacy of butylphthalide combined with alteplase in the treatment of ischemic acute cerebral infarction(ACI)and its prognostic influencing factors by logistic regression analysis.Methods A total of 153 patients with ischemic ACI admitted to the Quanzhou First Hospital from February 2020 to February 2023 were retrospectively selected,and all of them were treated with a combination of butylphthalide and rt-PA,and the prognosis of the patients was evaluated according to the mRS,and they were divided into the good prognosis group(n=122)and the poor prognosis group(n=31).The NIHSS was used to evaluate the treatment effect,and the data of gender,age,smoking history,time from onset to treatment,atrial fibrillation,family residence,NIHSS scores,marital status,education level,white blood cell count,and diabetes history were collected,and Logistic regression analysis was used to analyze the factors affecting the poor prognosis of patients with ischemic ACI after treatment.Results A total of 153 patients with ischemic ACI were included in this paper,and the total effective rate was 90.85%(139/153),including 122 patients in the good prognosis group and 31 cases in the poor prognosis group according to the results of follow-up mRs.The results of multivariate Logistic regression analysis showed that the risk factor for poor prognosis of patients with ischemic ACI after treatment were≥60 years,time from onset to treatment≥180 minutes,atrial fibrillation,NIHSS score≥15 points,abnormal white blood cell count,and history of diabetes mellitus(P<0.05 or P<0.01).Conclusions Treatment with butylphthalide combined with alteplase in patients with ischemic ACI can effectively help patients restore blood supply to brain tissue,and the overall treatment effect is good.However,there are still some patients with poor prognosis after receiving treatment,and there are many factors leading to poor prognosis,including age,time from onset to consultation,atrial fibrillation,NIHSS score,white blood cell

关 键 词：急性脑梗死 缺血性 丁苯酞 阿替普酶 近期疗效 影响因素 LOGISTIC回归分析 

分 类 号：R74[医药卫生—神经病学与精神病学]