急性缺血性卒中静脉溶栓近期疗效的影响因素研究

The research of the influencing factors on short - term efficacy of intravenous thrombolysis of acute ischemic stroke

目的探讨影响重组组织型纤溶酶原激活剂（rt．PA）静脉溶栓治疗近期（24h）疗效的因素。方法回顾性分析95例接受rt—PA静脉溶栓治疗的急性缺血性卒中患者的临床资料，对可能的影响因素进行多因素Logistic回归分析。结果静脉溶栓治疗后24h预后良好者56例（58．95％），多因素Logistic回归分析表明，影响近期疗效的因素为糖尿病（OR=3．933，95％CI1．199～12．897）和低分子肝素治疗急性卒中试验（TOAST）分型（OR=1．448，95％CI17032—2．032）。结论糖尿病和TOAST分型是影响rt—PA静脉溶栓近期疗效的主要因素，在筛选静脉溶栓患者及预测溶栓疗效时应予以关注。

Objective To explore the influencing factors on short - term efficacy of intravenous thrombolysis with rt - PA. Methods The clinical data of the 95 acute ischemic stroke （AIS） patients who received thrombolytic therapy were analyze. Multivariate logistic regression anal）sis was used to determine the possible influencing factors. Results Fifty - six（58.95 % ） patients had favourable outcomes after thrombolytic therapy for 24 hours. Multivariate logistic regression analysis indicated that diabetes（ OR = 3. 933,95% CI 1. 199 ~ 12. 897 ） and TOAST classification （OR = 1. 448,95% CI 1. 032 ~ 2. 032） were the independent predictors of short - terra outcome. Conclusion Diabetes and TOAST classification are the major influencing factors of short -term efficacy after intravenous thrombolysis with rt - PA. It should pay attention screening patients for intravenous thrombolysis therapy and predicting the efficacy of thrombolysis.