摘要
目的探讨轻度缺血性卒中患者静脉溶栓后不良结局的相关临床和放射学因素。方法选择2016-01-2018-03在解放军第985医院接受静脉溶栓治疗的轻度AIS患者为研究对象,所有患者采用阿替普酶静脉溶栓,记录患者的临床特征,溶栓前采用磁共振弥散加权成像(DWI)进行检查,观察患者临床特征及DWI特征与3个月时预后的相关性。结果预后不良患者占30.99%。单因素分析显示,预后不良和预后良好患者年龄、性别、高血压、房颤、吸烟、冠心病史、既往卒中或TIA史、发病至溶栓时间、基线收缩压、卒中病因、症状性颅内出血等差异无统计学意义(P>0.05),预后不良和预后良好患者糖尿病、高脂血症、NIHSS评分、基线血糖、DWI病变类型、终点事件等因素比较差异有统计学意义(P<0.05)。多因素Logistic分析显示,NIHSS评分、PAI+PAIP和终点事件是患者预后不良的独立因素(P<0.05)。结论轻度AIS经rt-PA静脉溶栓治疗后预后不良发生率30.99%,NIHSS评分、终点事件及MRI-DWI模式对预测轻度AIS患者静脉溶栓结局具有临床意义。
Objective To investigate the clinical and radiological factors associated with adverse outcomes afterintravenous thrombolysis in patients with mild ischemic stroke.Methods Patients with mild AIS who underwent intravenous thrombolytic therapy at the 985 th Hospital of PLA from Januray 2016 to March 2018 were selected as subjects.All patients were treated with alteplase intravenous thrombolysis.The clinical characteristics of patients were recorded before thrombolysis.Magnetic resonance diffusion-weighted imaging(DWI) was used to examine the clinical features and correlations between DWI characteristics and prognosis at 3 months.Results Patients with poor prognosis accounted for 30.99%.Univariate analysis showed poor prognosis and prognosis in patients with age,gender,hypertension,atrial fibrillation,smoking,history of coronary heart disease,previous stroke or TIA,onset to thrombolysis time,baseline systolic blood pressure,stroke etiology,symptomatic intracranial hemorrhage There were no significant differences between the two groups(P>0.05).There were significant differences in factors such as diabetes,hyperlipidemia,NIHSS score,baseline blood glucose,DWI lesion type,and endpoint events in patients with poor prognosis and prognosis(P<0.05).Multivariate logistic analysis showed that NIHSS score,PAI+PAIP,and endpoint events were independent factors for poor prognosis(P<0.05).Conclusion The incidence of poor prognosis of mild AIS after rt-PA intravenous thrombolysis is 30.99%.NIHSS score,end point event and MRI-DWI mode have clinical significance for predicting intravenous thrombolysis in patients with mild AIS.
作者
贾晓军
刘永兰
闫娟
陈思嘉
杨婕
JIA Xiaojun;LIU Yonglan;YAN Juan;CHEN Sijia;YANG Jie(The 985th Hospital of PLA,Taiyuan 030001,China)
出处
《中国实用神经疾病杂志》
2019年第22期2492-2497,共6页
Chinese Journal of Practical Nervous Diseases
关键词
轻度缺血性脑卒中
阿普替酶
静脉溶栓
磁共振弥散加权成像
预后
多因素分析
Mild ischemic stroke
Atropinase
Intravenous thrombolysis
Diffusion-weighted imaging of magnetic resonance
Prognosis
Multivariate analysis
