高龄急性缺血性脑卒中患者rt-PA静脉溶栓预后影响因素分析
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摘要
目的探讨影响重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗高龄(年龄≥80岁)急性缺血性脑卒中患者预后的相关因素分析。方法回顾性分析67例高龄急性缺血性脑卒中患者的相关临床资料,按90d临床结局改良Rankin量表(mRS)评分将患者分为预后良好组(mRS≤2分)和预后不良组(mRS>2分),以上数据均进行统计学描述,同时进行Logistic回归分析。结果多因素Logistic回归分析提示溶栓前舒张压、溶栓前血糖、24h神经功能缺损评分(NIHSS)均具有统计学意义(P<0.05)。结论对于高龄急性缺血性脑卒中患者静脉rt-PA溶栓,24hNIHSS评分、溶栓前血糖、溶栓前舒张压是影响其预后的独立影响因素。
Objective To analyze the prognostic factors of intravenous rt-PA thrombolytic therapy on elderly patients(≥80)with acute ischemic stroke.Methods Clinical data of 67 aged patients with acute ischemic stroke were analyzed retrospectively.Patients were divided into good-outcome group(mRS≤2) and bad-outcome group(mRS>2) according to the mRS score.These data were statistically described and were analyzed by the logistic multivariate analysis.Results Logistic multivariate analysis showed that baseline diastolic pressure,baseline blood glucose,and 24 hrs NIHSS score were all statistically significant(P<0.05).Conclusions Baseline blood glucose,baseline blood glucose and 24 hrs NIHSS score are the independent factors of intravenous rt-PA thrombolytic therapy for aged patients with acute ischemic stroke.
Objective To analyze the prognostic factors of intravenous rt-PA thrombolytic therapy on elderly patients(≥80)with acute ischemic stroke.Methods Clinical data of 67 aged patients with acute ischemic stroke were analyzed retrospectively.Patients were divided into good-outcome group(mRS≤2) and bad-outcome group(mRS>2) according to the mRS score.These data were statistically described and were analyzed by the logistic multivariate analysis.Results Logistic multivariate analysis showed that baseline diastolic pressure,baseline blood glucose,and 24 hrs NIHSS score were all statistically significant(P<0.05).Conclusions Baseline blood glucose,baseline blood glucose and 24 hrs NIHSS score are the independent factors of intravenous rt-PA thrombolytic therapy for aged patients with acute ischemic stroke.
引文
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[7]Dharmasaroja PA,Muengtaweepongsa S,Dhar masaroja P.Early outcome after intravenous thrombolysis in patients withacute ischemic stroke[J].Neurol India,201l,59(3):351-354.
[8]Rocco A,Heuschmann PU,Schellinger PD,et al.Glycosylated hemoglobin A1 predicts risk for symptomatic hemorrhage after thrombolysis for acute stroke[J].Stroke,2013,44(8):2134-2138.
[2]Fonarow GC,Reeves MJ,Zhao X,et al.Age-related differences in characteristics,performance measures,treatment trends,and outcomes in patients with ischemic stroke[J].Circulation,2010,121(7):879-891.
[3]中国卒中学会科学声明专家组.急性缺血性卒中静脉溶栓中国卒中学会科学声明[J].中国卒中杂志,2017,12(3):267-284.
[4]重组组织型纤溶酶原激活剂治疗缺血性卒中共识专家组.重组组织型纤溶酶原激活剂静脉溶栓治疗缺血性卒中中国专家共识[J].中华内科杂志,2012,51(12):1006-1008.
[5]Menon BK,Qazi E,Nambiar V,et al.Differential effect of baseline computed tomographic angiography collaterals on clinical outcome in patients enrolled in the interventional management of stroke III Trial[J].Stroke,2015,46(5):1239-1244.
[6]李鸿飞,徐冬娟,张为强.80岁以上急性缺血性脑卒中患者rt-PA静脉溶栓治疗的预后影响因素分析[J].全科医学临床与教育,2017,15(3):272-275.
[7]Dharmasaroja PA,Muengtaweepongsa S,Dhar masaroja P.Early outcome after intravenous thrombolysis in patients withacute ischemic stroke[J].Neurol India,201l,59(3):351-354.
[8]Rocco A,Heuschmann PU,Schellinger PD,et al.Glycosylated hemoglobin A1 predicts risk for symptomatic hemorrhage after thrombolysis for acute stroke[J].Stroke,2013,44(8):2134-2138.