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静脉溶栓后早期神经功能改善的急性脑梗死患者预后良好 被引量:11

Patients with Acute Cerebral Infarction with Improved Early Neurological Function after Intravenous Thrombolysis Have a Good Prognosis
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摘要 目的:评价早期神经功能改善与急性缺血性卒中患者发病90 d后预后的关系。方法:回顾性分析急性缺血性脑卒中并接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗患者的临床资料。所有患者溶栓前和溶栓后1 h采用美国国立卫生研究院卒中量表(NIHSS)进行评分。将早期神经功能改善定义为溶栓后1h NIHSS评分减少≥5分或NIHSS评分=0分,用改良Rankin量表(mRS)评分来评估90 d预后,运用Logistic回归模型来分析患者早期神经功能改善和90 d预后的相关性。结果:纳入94例患者,在溶栓后1 h,早期神经功能改善27例(28.72%)。多因素Logistic回归分析提示,早期神经功能改善是90 d良好预后的独立预测因子(OR 6.79;95%CI 1.73~26.61,P<0.01)。结论:急性缺血性卒中患者接受rt-PA静脉溶栓后,早期神经功能改善则90 d后具有良好预后。 Objective: To evaluate the relationship between the improvement of early neurological function and the prognosis of patients with acute ischemic stroke after onset of 90 d. Methods: All patients underwent throm- bolysis prior to thrombolysis with a National Institutes of Health Stroke Scale (NIHSS) score, retrospectively analyzed for acute ischemic stroke and received intravenous thrombolysis with recombinant tissue plasminogen acti- vator (rt-PA), 1 h after thrombolysis NIHSS score. The improvement of early neurological function was defined as 1h after thrombolysis NIHSS score reduction ≥5 points or NIHSS score = 0, with modified Rankin scale (mRS) score to evaluate the 90 d prognosis, The use of Logistics regression model to analyze the correlation between early neurological improvement and prognosis at 90 days in patients. Results: Ninety-four patients were enrolled in this study. In the In'st hour after thrombolysis, there were 27 cases (28.72%) of early neurological improvement..Multivariate Logistic regression analysis showed that early neurological improvement was an independent predictor of 90-day good prognosis (OR 6.79; 95% CI1.73-26.61, P〈0.01). Conclusion: After rt-PA intravenous thrombolysis, acute ischemic stroke patients with early neurological improvement after 90 d had a good prognosis.
出处 《神经损伤与功能重建》 2017年第6期497-500,共4页 Neural Injury and Functional Reconstruction
关键词 急性缺血性卒中 溶栓 预后 早期神经功能改善 acute ischemic stroke thrombolysis outcome early neurologic improvement
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  • 1Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke[J]. N Engl J Med, 2008, 359: 1317-1329.
  • 2Del Zoppo GJ, Saver JL, Jauch EC, et al. Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator a science advisory from the American Heart Association/American Stroke Association[J]. Stroke 2009, 40: 2945-2948.
  • 3Mazighi M, Serfaty JM, Labreuche J, et al Comparison of intravenous alteplase with a combined intravenous-endovascular approach in patients with stroke and confirmed arterial occlusion (RECANALISE study): a prospective cohort study[J]. Lancet Neurol, 2009, 8: 802-809.
  • 4Muresan IP, Favrole P, Levy P, et al. Very early neurologic improvement after intravenous thrombolysis[J]. Arch Neurol, 2010, 67: 1323-1328.
  • 5Takagi T, Kato T, Sakai H, et al. Early neurologic improvement based on the National Institutes of Health Stroke Scale score predicts favorable outcome within 30 minutes after undergoing intravenous recombinant tissue plasminogen activator therapy[J]. J Stroke Cerebrovasc Dis, 2014, 23: 69-74.
  • 6Liao XL, Wang CX, Wang YL, et al. Implementation and outcome of thrombolysis with alteplase 3 to 4.5 h after acute stroke in Chinese patients[J]. CNS Neurosci Ther, 2013, 19: 43-47.
  • 7Saposnik G, Di Legge S, Webster F, et al. Predictors of major neurologic improvement after thrombolysis in acute stroke[J]. Neurology, 2005, 65: 1169-1174.
  • 8Hallevi H, Grotta JC. SITS-MOST: old myths laid to rest[J]. Lancet Neurol, 2007, 6: 292-293.
  • 9Sulter G, Steen C, De Keyser J. Use of the Barthel index and modified Rankin scale in acute stroke trials[J]. Stroke, 1999, 30: 1538-1541.
  • 10Haley EC, Jr, Lewandowski C, Tilley BC. Myths regarding the NINDS rt-PA Stroke Trial: setting the record straight[J]. Ann Emerg Med, 1997, 30: 676- 682.

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