影响脑梗死静脉溶栓预后的相关因素分析

Analysis of risk factors influencing prognosis of patient after intravenous thrombolytic therapy

目的探讨可能影响脑梗死患者静脉溶栓预后的因素。方法 69例急性脑梗死患者给予阿替普酶(recombi-nant tissue plasminogen activator,rt-PA)治疗,以90d时改良Rankin量表(mRS)评分作为疗效指标,0～1分者为预后良好,2～6分包括死亡为预后不佳,并对影响因素做Logistic回归分析。结果预后良好23例(33.3%),预后不良46例(66.67%)。经回归分析显示糖尿病、颈内或大脑中动脉闭塞为预后的独立预测因素。结论脑梗死合并糖尿病、颈内或大脑中动脉闭塞患者静脉溶栓预后不佳。

Objective To investigate the risk factors that may influence the prognosis of patient after intravenous thrombolytic therapy. Methods Eligible patients with acute ischemic infarction were treated with recombinant tissue plasminogen activator, the modified Rankin scale score was used to measure the outcome. Favorable outcome was defined as 0- 1 and adverse outcome as 2~6 including death. Multivariable logistic regression method was used to analyze predictors. Results Sixty-nine patients were included in the research and the mean age was （58.53--11.75） years old. A favorable outcome was observed in 23 patients（33.3%）. The presence of diabetes and occlusion of ICA or MCA were independent predictors. Conclusion For pa tients treated with rt PA with diabetes or an occlusion of ICA or MCA probably have an adverse outcome.