影响尿激酶静脉溶栓治疗急性脑梗死预后因素的初步分析

Pilot Study of Factors Influencing Outcoming of Acute Ischemic Stroke Treated with Urokinase

目的:对影响急性缺血性脑卒中患者应用尿激酶溶栓治疗预后的相关危险因素进行初步分析及研究,为今后选择适宜应用尿激酶溶栓的患者打下基础。方法:以2015年1月1日至2015年10月31日入院且应用尿激酶静脉溶栓的38例急性缺血性脑卒中患者,根据治疗3个月后的预后情况将患者分为A组(24例,预后良好)和B组(14例,预后不良),对两组患者的预后影响因素进行分析。结果:预后良好组患者的溶栓前NIHSS评分低于预后不良组,差异具有统计学意义(P<0.05)。多因素的Logistic回归分析显示,吸烟和HINSS评分与急性脑梗死尿激酶溶栓预后不良有关,差异具有统计学意义(P<0.05),且NIHSS评分是预后的独立预测因素。结论:尿激酶静脉溶栓治疗脑梗死的患者,溶栓前较高的NIHSS评分可能与溶栓预后不良有关。吸烟的患者溶栓后出现预后不良的几率是不吸烟患者溶栓后预后不良的8.83倍,溶栓前NIHSS评分每增加1分,溶栓预后不良的几率增加1.76倍。

Objective： Pilot study and analysis of prognosis and risks regarding urokinase for acute ischemic stroke. This study will form foundation for candidate selection for the use of urokinase. Methods： 38 cases of acute ischemic stroke admission treated with intravenous urokinase from 1/1/2015 to 31/10/2015 are divided into A（24 participants, favorable outcome） and B group（unfavourable outcome） based on prognosis after three months. Factors associated with different outcomes are discussed in this study. Results： NIHSS score from favorable outcome group was lower than unfavourable outcome group（with statistical significance, P0.05）. NIHSS scoreis the independent predictors of prognosis. Conclusions： Conclusion： in acute ischemic stroke patient treated with intravenous urokinase,higher NIHSS score may be associated with poorer outcome. Patients who smoke are 8.83 times more likely to encounter poor outcome.With every point increase of NIHSS score prior to thrombolysis, the odds of unfavorable outcome was increased by 1.76 times.