摘要
目的分析老年急性脑梗死(ACI)病人行静脉溶栓治疗前后凝血功能的变化及预后的影响因素。方法选取103例接受溶栓治疗的老年ACI病人作为ACI组,80例体检健康者作为对照组。检测病人溶栓治疗前后活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)及D-二聚体(DD)水平,分析影响老年ACI病人静脉溶栓预后的相关因素。结果治疗前,ACI组的APTT、PT均显著短于对照组,DD水平显著高于对照组(P<0.05)。治疗后,ACI组的APTT、PT均高于治疗前(P<0.05),但与对照组相比,差异无统计学意义(P>0.05);DD水平显著低于治疗前,但仍高于对照组(P<0.05)。ACI组治疗前后及与对照组比较,TT差异均无统计学意义(P>0.05)。溶栓治疗后1个月,总有效率为84.47%;治疗后3个月,预后良好率为61.17%。多因素Logistic回归分析结果显示,年龄≥75岁、溶栓前NIHSS评分≥15分、溶栓24 h后NIHSS评分无改善、发病至溶栓时间≥3 h、溶栓前血糖≥11.1 mmol/L是影响老年ACI静脉溶栓预后的危险因素(P<0.05)。结论溶栓治疗可显著改善老年ACI病人的凝血功能。此外,年龄≥75岁、溶栓前NIHSS评分≥15分、溶栓24 h后NIHSS评分无改善、发病至溶栓时间≥3 h、溶栓前血糖>11.1 mmol/L是影响老年ACI病人静脉溶栓预后的危险因素。
Objective To analyze the changes of coagulation function and the influencing factors of prognosis in the elderly patients with acute cerebral infarction(ACI)before and after intravenous thrombolysis.Methods A total of 103 elderly ACI patients treated with thrombolysis were enrolled as the AC I group and 80 healthy people enrolled as the control group.The activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT)and D-Dimer(DD)level were tested before and after thrombolysis.The influencing factors of prognosis in the elderly ACI patients were analyzed.Results Before treatment,the leves of APTT and PT in the ACI group were significantly lower than those in the control group,and DD level was significantly higher(P<0.05).After treatment,the levels of APTT and PT in the ACI group were higher than those before treatment(P<0.05),but showed no significant difference from the control group(P>0.05);DD level in the ACI group was significantly lower than that before treatment,but still higher than that in the control group(P<0.05).There was no significant difference in TT of ACI group before and after treatment and comepared with control group(P>0.05).One month after treatment,the total effective rate was 84.47%.Three months after treatment,the good prognosis rate was 61.17%.Multivariate Logistic regression analysis showed that aged 75 years or older,National Institutes of Health Stroke Scale(NIHSS)score before thrombolysis≥15,no improvement in NIHSS score after 24 hours of thrombolysis,time between onset and thrombolysis≥3 hours,and blood glucose before thrombolysis≥11.1 mmol/L were independent risk factors of the prognosis of intravenous thrombolysis in the elderly ACI patients(P<0.05).Conclusions Thrombolysis can significantly improve the coagulation function of elderly patients with ACI.In addition,NIHSS score before thrombolysis≥15,no improvement in NIHSS score after 24 hours of thrombolysis,time between onset and thrombolysis≥3 hours,and blood glucose before thrombolysis≥11.1 mmol/L
作者
田轶
唐思治
罗霄鹏
TIAN Yi;TANG Si-zhi;LUO Xiao-peng(Department of Neurology,Zhuzhou Central Hospital,Zhuzhou 412000,China)
出处
《实用老年医学》
CAS
2020年第5期479-483,共5页
Practical Geriatrics
关键词
老年人
急性脑梗死
静脉溶栓
预后
影响因素
aged
acute cerebral infarction
intravenous thrombolysis
prognosis
influencing factor
