不同溶栓时间窗信息对脑梗死患者溶栓决策行为的影响

Effects of thrombolytic infornmtion in different time windows upon thrombolytic decision maldng in patients with cerebral infarction

目的在“急性脑梗死溶栓治疗”情境下，探讨框架信息与溶栓时间窗信息对脑梗死患者及其家属溶栓风险决策的影响。方法以神经内科住院及门诊的脑梗死患者及其家属（n=327）为研究对象，将其随机分为正面框架组（n=187）和负面框架组（n=140），每组被试均接受三种不同溶栓时间窗条件下的溶栓风险信息。结果无论在何种溶栓时间窗条件下，被试在正面框架和负面框架信息条件下溶栓倾向差异无统计学意义（0～90min：χ^2=1．24，P〉0.05；91～180min：χ^2=0．35，P〉0．05；181～270min：χ^2=0．07，P〉0.05）；在负面框架条件下，与接受181-270min溶栓信息相比，被试在接受0-90min溶栓信息时溶栓倾向显著增强（6913％vs51．5％，P〈0.05）。结论溶栓信息框架与溶栓时间窗共同作用影响被试的溶栓决策偏好。应根据不同的溶栓时间节点向患者呈现相应的溶栓风险信息。

Objective To discuss the influence of framing information and time window information upon risk decision making about thrombolysis therapy in patients with cerebral infarction or their relatives in the scenarios of thrombolytic therapy for acute cerebral infarction. Methods Inpatients and outpatients with cerebral infarction or their relatives（ n= 327） were randomly divided into positive framing group（ n= 187） and negative framing group（ n= 140）. Every participant underwent risky messages about thrombolytic treat- ment in three different time windows：0-90 minutes, 91-180 minutes and 181-270 minutes. Results In any thrombolytic time window condition, there was no significant difference in thrombolytic tendency of partici- pants between the positive framing group and the negative framing group （0-90 min：χ^2 = 1.24, P〉 0.05 ;91- 180 minutes ：χ^2 = 0.35,P〉0.05 ; 181-270 minutes ： χ^2 = 0.07,P〉0.05） .In a negative framework conditions, compared with the participants receiving thrombolytic information in 181-270 minutes time window,subjects receiving thrombolytic information in 0-90 minutes window were more tolerant of thrombolytic treatment （ 69.3 % vs 51.5 %, P〈0.0125）. Conclusion There are mutual effects of time window and framing information upon participants＇ preferences for thrombolysis. Different thrombolytic information are presented according to their corresponding time windows.