摘要
目的分析老年急性缺血性脑卒中(AIS)患者静脉溶栓后早期神经功能恶化(END)的相关因素。方法回顾性分析118例接受溶栓治疗的AIS患者的临床资料,根据是否发生END分为END组28例和非END组90例,单因素分析比较两组患者一般资料、临床资料、实验室指标以及类肝索药物急性卒中治疗试验(TOAST)分型、梗死部位、责任血管狭窄程度,采用多因素Logistic回归分析发生END的相关因素。结果单因素分析结果显示,END组患者患有糖尿病和既往脑梗死的比例显著高于非END组(χ^(2)=4.000、8.056,P=0.046.0.005);两组患者入院时美国国立卫生院卒中量表(NIHSS)评分、发病至溶栓时间、溶栓时间、吞咽功能障碍、白蛋白、白细胞计数、中性粒细胞计数、淋巴细胞计数、糖化血红蛋白(HbAlc)、肌酐、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C).脂蛋白a水平的差异均有统计学意义(均P<0.05);两组患者卒中TOAST分型、梗死部位、责任血管狭窄程度的差异均有统计学意义(χ^(2)=13.109、9.509,Z=2.912,P=0.004、0.023、0.004)。多因素Logistic回归分析结果显示,人院时NIHSS评分、HbA1c、心源性卒中、责任血管狭窄程度、白细胞计数为END发生的独立相关因素(OR=1.122、2.131、1.965、1.876、1.563,P=0.036、0.024、0.028.0.030、0.041)。结论人院时NIHSS评分、HbA1c、心源性卒中、责任血管狭窄程度、白细胞计数为END发生的独立相关因素,应重点监测并制定防治措施,以期改善AIS患者预后。
Objective To analyze the risk factors for early neurological deterioration(END)in elderly patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods Clinical data of 118 patients with AIS who had received thrombolysis were collected retrospectively.According to the occurrence of END,cases were divided into the END group(n=28)and the non-END group(n=90).Univariate analysis was used to compare general characteristics,clinical data,laboratory test results,TOAST classification,infarct location,and degree of culprit vessel stenosis between the two groups.Multivariate Logistic regression analysis was used to analyze the related factors for END.Results Univariate analysis showed that the proportion of patients with diabetes mellitus and previous cerebral infarction was higher in the END group than in the non-END group(χ^(2)=4.000 and 8.056,P=0.046 and 0.005).There were significant differences in National Institutes of Health Stroke Scale(NIHSS)score,time from onset to thrombolysis,thrombolysis time,swallowing dysfunct10n,albumin,leukocyte count,neutrophil count,lymphocyte count,glycosylated hemoglobin(HbAlc),creatinine,total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density hpoprotem cholesterol(HDL-C)and lipoprotein(a)levels between the two groups(all P<0.05).There were also significant differences between the two groups in TOAST classification,infarct location and degree of culpritvessel stenosis(χ^(2)=13.109 and 9.509,Z=2.912,P=0.004,0.023 and 0.004).Multivariate Logistic regression analysis showed that NIHSS score,HbAlc,cardiogenic stroke,degree of culprit vessel stenosis and leukocyte count on admission were independent risk factors for END(OR=1.122,2.131,1.965,1.876 and 1.563,P=0.036,0.024,0.028,0.030 and 0.041).Conclusions NIHSS score,HbAlc,cardiogenic stroke,degree of culprit vascular stenosis and leukocyte count on admission are independent risk factors for END,which should be closely monitored and managed with well formulated preventive measures in order to improve t
作者
李娜
吴芬香
李涛
侯倩
吉维忠
才鼎
Li Na;Wu Fenxiang;Li Tao;Hou Qian;Ji Weizhong;Cai Ding(Department of Neurology,Qinghai People's Hospital,Xining 810007,China;Department of Orthopedics,Qinghai People's Hospital,Xining 810007,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2021年第8期1005-1009,共5页
Chinese Journal of Geriatrics
基金
青海省卫生健康委员会一般指导性课题(2019-wjzdx-30)。
关键词
卒中
血栓溶解疗法
神经功能恶化
Stroke
Thrombolytic therapy
Neurological deterioration
