【摘要】 目的探讨轻型卒中或TIA患者静脉溶栓后短期不良结局的危险因素。方法纳入自2019年10月至2020年7月就诊于苏州大学附属第一医院予以静脉溶栓的基线NIHSS评分0～5分的轻型卒中或TIA患者94例,将其按发病14 d mRS评分分为不良结局组(mRS>1分)28例和良好结局组(mRS≤1分)66例,对基线指标以及危险因素进行单因素和多因素分析。结果年龄(OR=1.049,95%CI:1.003～1.096,P=0.035)、无责任大血管狭窄也无错配区(OR=2.808,95%CI:1.051～7.504,P=0.040)为溶栓后不良结局的独立危险因素。在CTA-Mismatch-亚组中,存在基线运动功能缺损(基线NIHSS评分中肌力评分≥1分)是患者预后不良的预测因子(P=0.004)。结论对基线NIHSS评分0～5分的患者进行溶栓决策时应将临床症状与多模式CT结合,对CTA-Mismatch-患者溶栓需谨慎。更多还原

【Abstract】 Objective To find the risk factors predicting short-term poor outcomes of mild stroke or TIA patients after intravenous thrombolysis. Methods Ninety-four mild stroke or TIA patients after intravenous thrombolysis with baseline NIHSS score of 0-5 were enrolled in the First Affiliated Hospital of Soochow University from October 2019 to July 2020. According mRS scores at 14 d after onset, patients were divided into poor outcome group(mRS>1, n=28)and good outcome group(mRS≤1, n=66). The baseline index and risk factors were analyzed by univariate and multivariate analysis. Results Age(OR=1.049, 95%CI:1.003-1.096,P=0.035),CTA-Mismatch-(OR=2.808, 95%CI:1.051-7.504, P=0.040) were independent risk factors for the adverse outcome of thrombolytic therapy. In the CTA-Mismatch-subgroup, the baseline motor dysfunction symptom(strength item of baseline NIHSS≥1 point)was a predictor of poor outcome(P=0.004). Conclusion When making thrombolytic decision, we should pay attention to both clinical symptoms and multi-mode CT and be careful to treat patients with CTA-Mismatch-.更多还原