入院血糖和发病到治疗时间对急性缺血性脑卒中静脉溶栓预后的影响

Analysis of Relationship between Blood Glucose at Admission and Time from Symptom Onset to Treatment with Prognosis After Intravenous Thrombolysis in Acute Ischemic Stroke

目的:分析入院时血糖水平和发病到治疗的时间(ONT)对静脉溶栓治疗急性缺血性脑卒中预后的影响。方法:回顾性分析我院通过卒中绿色通道收治的接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓的急性缺血性脑卒中107例患者的临床资料,按溶栓后24 h内美国国立卫生院脑卒中量表(NIHSS)评分变化值分为有效组43例及无效组64例。比较2组的临床资料,并分析预后的影响的因素。结果:有效组90 d改良Rankin量表(mRS)评分低于无效组(P<0.05),有效组ONT和入院时血糖均低于无效组(P<0.05);多因素Logistic回归分析显示ONT(OR=0.992,P=0.025)和入院时血糖水平(OR=0.746,P=0.022)可能是影响预后的预测因素。结论:尽早实施溶栓治疗和积极控制血糖水平可能是改善急性缺血性脑卒中患者预后的重要措施。

Objective： To investigate the correlation between blood glucoseat admission and time from symptom onset to treatment （ONT） with prognosis after intravenous thrombolytic therapy in patients with acute ischemic stroke. Methods： A total of 107 acute ischemic stroke patients who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator （rt-PA） were retrospectively analyzed. They were divided into the effective group （43 cases） and the ineffective group （64 cases） according to National Institute of Health Stroke Scale （NIHSS） scores 24 h after intravenous thrombolytic therapy. Clinical data of the two groups were compared, and factors correlated with prognosis were analyzed. Results： The 90 d modified Rankin Scale （mRS） score of the effective group was lower than that of the ineffective group （P〈0.05）. The ONT and blood glucose at admission were both lower in the effective group than those in the ineffective group （P〈0.05）.Multiple Logistic regression analysis indicated ONT （OR=0.992, P=0.025） and blood glucose level at admission （OR=0.746, P=0.022） were factors correlated with prognosis. Conclusion： Implementing intravenous thrombolytic therapy as soon as possible and controlling blood sugar levels may be important steps in improving prognosis in patients with acute ischemic stroke.