阿替普酶治疗急性缺血性脑卒中的疗效及预后影响因素分析

Efficacy and Prognostic Factors of Alteplase in the Treatment of Acute Ischemic Stroke

目的观察阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效,分析阿替普酶治疗急性缺血性脑卒中预后的影响因素。方法回顾性分析2015年7月至2016年7月于我院接受阿替普酶静脉溶栓治疗的急性缺血性脑卒中患者37例临床资料,用NIHSS评分评价患者神经功能缺损程度,用mRS评分评价患者预后,并分析影响溶栓治疗预后的因素。结果阿替普酶治疗前和治疗后24h NIHSS评分差异有统计学意义(P<0.05)。阿替普酶治疗后3个月,预后良好组21例,预后不良组16例,分析得出入院时收缩压、溶栓前NIHSS评分、发病至溶栓开始时间是影响阿替普酶治疗预后的独立危险因素。结论阿替普酶静脉溶栓治疗急性缺血性卒中能明显改善患者神经功能缺损程度,改善患者预后。入院时收缩压、溶栓前NIHSS评分、发病至溶栓开始时间是影响阿替普酶治疗预后的独立危险因素。

Objective To observe the efficacy of alteplase,an intravenous thrombolytic drug,on acute ischemic stroke,and to analyze the influencing factors of the effect of alteplase on the prognosis of acute ischemic stroke.Methods We retrospectively analyzed the clinical data of 37 patients with acute ischemic stroke treated with intravenous thrombolytic therapy of alteplase from July 2015 to July 2016 in our hospital.The NIHSS score was used to evaluate the degree of neurological deficit in patients.The prognosis was evaluated by mRS score and the influencing factors of prognosis were analyzed. Results The difference of NIHSS score between the two groups before and after treatment was statistically significant（ P〈0. 05）.After 3 months of treatment with alteplase,21 patients had good prognosis and 16 patients had poor prognosis.Systolic blood pressure on admission,NIHSS score before thrombolytic therapy,and time of thrombolytic therapy were independent risk factors that affects the prognosis.Conclusion Intravenous thrombolytic drug alteplase can significantly improve the degree of neurological deficit and improve the prognosis of patients with acute ischemic stroke.Systolic blood pressure on admission,NIHSS score before thrombolytic therapy,and time of thrombolytic therapy were independent risk factors of the effect of alteplase on the prognosis of acute ischemic stroke.