【摘要】 目的 探讨急性脑梗死患者阿替普酶（rt-PA）静脉溶栓治疗的预后情况，并分析其相关影响因素。方法 将120例急性脑梗死患者随机分为对照组（60例）和观察组（60例）。对照组予以常规治疗，观察组在对照组基础上予以rt-PA静脉溶栓治疗，比较两组患者治疗后3个月的神经功能（NIHSS评分）、日常活动能力（BI评分）及预后情况（m RS评分）。根据mRS评分将观察组分为预后良好和预后不佳两个亚组，并通过单、多因素Logistic模型分析影响其预后的相关因素。结果 治疗后3个月，观察组的NIHSS、 mRS评分低于对照组，BI评分高于对照组（P <0.05）。观察组预后良好53例，预后不佳7例；经单因素和多因素Logistic分析显示，心脏疾病史、糖尿病、营养状况是影响观察组患者预后的独立因素（P <0.05）。结论 rt-PA静脉溶栓治疗有利于急性脑梗死患者预后恢复，而心脏疾病史、糖尿病、营养不良会影响其预后情况。更多还原

【Abstract】 Objective To explore the prognosis of patients with acute cerebral infarction undergoing alteplase(rt-PA) intravenous thrombolysis, and analyze the related influencing factors. Methods 120 patients with acute cerebral infarction were randomly divided into control group(60 cases) and observation group(60 cases). The control group was given routine treatment, and the observation group was treated with rt-PA intravenous thrombolysis on the basis of the control group. The neurological function(NIHSS score), daily activity ability(BI score) and prognosis(m RS score) at 3 months after treatment were compared between the two groups. According to the m RS score, the observation group was divided into two subgroups(good prognosis and poor prognosis), and the related factors affecting the prognosis were analyzed by univariate and multivariate Logistic model. Results 3 months after treatment, the NIHSS and m RS scores of the observation group were lower than those of the control group, and the BI score was higher than that of the control group(P <0.05). In the observation group, 53 cases had good prognosis and 7 cases had poor prognosis. Univariate and multivariate Logistic analysis showed that the heart disease history, diabetes mellitus and nutritional status were independent factors affecting the prognosis of the observation group(P <0.05).Conclusions rt-PA intravenous thrombolysis is beneficial to the prognosis recovery of patients with acute cerebral infarction, while the heart disease history, diabetes mellitus and malnutrition will affect the prognosis of patients.更多还原