【摘要】 目的分析急性脑梗死(ACI)患者重组组织型纤溶酶原激活剂(rt-PA,商品名:阿替普酶)静脉溶栓治疗预后影响因素。方法回顾性分析接受rt-PA静脉溶栓治疗的72例ACI患者临床资料,按治疗后第90天改良Rankin量表(mRS)评分,分为预后良好组(0～1分)及预后不良组(2～6分),采用多因素Logistic回归分析确定与预后相关的因素。结果预后良好组患者41例,预后不良组患者31例;溶栓前美国国立卫生研究院卒中量表(NIHSS)评分[优势比(OR)=1.179,95%置信区间(95%CI):1.032～1.348]、发病至溶栓时间(OR=1.014,95%CI:1.008～1.025)、溶栓前血糖(OR=1.847,95%CI:1.248～2.733)与静脉溶栓治疗后3个月功能良好预后独立相关(P<0.05)。结论溶栓前NIHSS评分、发病至溶栓时间、溶栓前血糖是ACI患者rt-PA静脉溶栓预后的独立影响因素。更多还原

【Abstract】 Objective To identify the observe the risk factors of the prognosis in patients with acute cerebral infarction(ACI after intravenous thrombolysis with recombinant tissue type plasminogen activitor(rt-PA,trade name:alteplase).Methods Clinical data of 72 patients with ACI,receiving rt-PA intravenous thrombolysis,were collected.According to the modified Rankin scale(mRS)score on the 90 th day after treatment,the patients were divided into good outcome group(0-1 point)and poor outcome group(2-6 points).Logistic regression analysis was used to evaluate the factors in predicting the outcome of patients.Results After treatment,41 patients were with good outcomes,and 31 patients were with poor outcomes.National Institutes of Health Stroke Scale(NIHSS)score before thrombolysis(OR=1.179,95%CI:1.032-1.348),thrombolysis time(OR=1.014,95%CI:1.008-1.025),and blood glucose level before thrombolysis(OR=1.847,95%CI:1.248-2.733)were independently associated with good prognosis at 3 months after intravenous thrombolytic therapy.Conclusion The NIHSS score before thrombolysis,thrombolysis time,and blood glucose level before thrombolysis could be independent factors influencing the prognosis of rt-PA intravenous thrombolysis in patients with ACI.更多还原