| 刘 芳,林金生,唐 颖,袁 颖,潘海泉.rt-PA治疗急性脑梗死的近期临床疗效及其影响因素分析[J].,2017,17(8):1527-1529 |
| rt-PA治疗急性脑梗死的近期临床疗效及其影响因素分析 |
| Short-term Efficacy and Influencing Factors of Recombinant Tissue Plasminogen Activator in the Treatment of Acute Cerebral Infarction |
| 投稿时间：2016-09-29 修订日期：2016-10-26 |
| DOI：10.13241/j.cnki.pmb.2017.08.032 |
| 中文关键词: 脑梗死 组织型纤溶酶原激活物 近期疗效 |
| 英文关键词: Brain Infarction Recombinant Tissue Plasminogen Activator Short-term Efficacy |
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| 中文摘要: |
| 摘要 目的：探讨重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator，rt-PA)溶栓治疗急性脑梗死的近期临床疗效及其影响因素。方法：回顾性分析2013年8月至2015年1月于我院神经内科接受rt-PA溶栓治疗的88例急性脑梗死患者的临床资料，分析患者入院及发病24h的美国国立卫生研究院卒中量表(NIHSS)评分，以评分的差值作为结局变量，分为预后良好的观察组(NIHSS差值≥4分或≥50%)及预后不良的对照组(NIHSS差值＜4分或＜50%)。选取溶栓前临床及实验室资料，筛选不良预后的可能影响因素，并进行单因素及多因素分析。结果：88例患者溶栓治疗后近期预后良好者46例(52.27%)，预后不良者42例(47.73%)。4.5 h内接受溶栓者好转率为57.14%(36/63)，＞4.5 h接受溶栓者好转率为32.00%(8/25)，显著低于4.5h内接受溶栓者，差异具有统计学意义(P＜0.05)。单因素分析结果显示糖尿病史、高密度脂蛋白、血糖、溶栓时间窗、NIHSS评分变量是影响rt-PA溶栓疗效的因素，进一步多因素分析结果显示溶栓时间窗、血糖、NIHSS评分是影响rt-PA溶栓疗效的因素。结论：rt-PA静脉溶栓治疗急性脑梗死的近期疗效有明显的时间依赖性，且血糖、NIHSS评分为早期预后的影响因素。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the short-term efficacies and influencing factors of recombinant tissue plasminogen activator (rt-PA) for acute cerebral infarction. Methods: The clinical data were analyzed retrospectively for 88 patients with acute cerebral infarction on rt-PA thrombolytic therapy from September 2012 to September 2014 at our neurology department. The NIH stroke scale (NIHSS) scores were assessed when the patient were admitted to hospital and 24 hours after thrombolysis. Then the difference-value as outcome variables, they were divided into observation group (NIH-SS difference ≥4 points or ≥50% ) and matched control group (NIHSS difference <4 <50% ). By selecting the pre-thrombolysis clinical and laboratory data, then the univariate and multivariate analyses were performed to screening the possible factors associated with a poor prognosis were screened. Results: After the thrombolytic therapy, 46 patients (52.27%) had a good prognosis and 42 (47.73% ) a poor prognosis. The improvement rate was 57.14%(36/63) about the patient who received the thrombolytic therapy within 4.5h; the improvement rate was 32.00%(8/25)about the patient who received the thrombolytic therapy beyond 4.5 h and the improvement rate were significantly lower than the patient who received the thrombolytic therapy within 4.5h (P<0.05). The results of univariate statistical analysis showed that the influencing factors of thrombolytic efficacy included diabetes, high-density lipoprotein, blood sugar ,thrombolytic time window,and NIHSS score. Conclusion: Recombinant tissue plasminogen activator in the treatment of acute cerebral infarction have a distinct time dependence. Blood glucose and NIHSS score are the influencing factors of early prognosis. |
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