【摘要】 目的探讨基础侧支循环情况与超常规时间窗(OTT> 4.5 h)进行rt-PA静脉溶栓治疗脑梗死预后的相关性。方法采用回顾性研究法收集OTT> 4.5 h的急性颈内动脉系统脑梗死患者且接受rt-PA静脉溶栓治疗的患者91例,根据溶栓后90 d的mRS作为评价临床结局是否良好的指标,分为结局良好组(51例)及结局不良组(40例),利用rLMC评分评估侧支循环。结果两组患者的基线NIHSS评分、rLMC评分(0～10)比较存在明显的统计学差异(P <0.05)。多因素二分类Logistic回归分析结果显示:基线NIHSS评分及rLMC评分(0～10)是影响超时间窗溶栓患者的远期预后的独立危险因素(P <0.05)。结论急性脑梗死患者的基线NIHSS及rLMC评分是静脉rt-PA溶栓后90 d预后结果的预测因子。更多还原

【Abstract】 Objective To investigate the correlation between the basic collateral circulation and the prognosis of cerebral infarction treated by rtPA intravenous thrombolysis with OTT>4.5 hours. Methods Ninety-one patients with acute internal carotid artery system ischemic stroke with OTT>4.5 hours and received rt-PA treatment were collected retrospectively. According to the MRS score of 90 days after thrombolysis, the patients were divided into good outcome group(n=51) and poor outcome group(n=40). Results The baseline NIHSS score and rLMC score(0-10) of the two groups were significantly different(P<0.05). The results of multivariate binary logistic regression analysis showed that the baseline NIHSS score and rLMC score(0-10) were independent risk factors affecting the long-term prognosis of patients with thrombolysis over time window(P<0.05). Conclusion The baseline NIHSS and rLMC scores of patients with acute cerebral infarction are predictors of prognosis 90 days after intravenous rt-PA thrombolysis.更多还原