急性缺血性卒中患者阿替普酶静脉溶栓后发生早期神经功能恶化的危险因素分析

Risk factors of early neurological deterioration after intravenous thrombolysis by alteplase for patients with acute ischemic stroke

目的 探讨急性缺血性卒中患者阿替普酶静脉溶栓后发生早期神经功能恶化的危险因素。方法 选取2016年7月至2018年8月本院就诊并采取阿替普酶静脉溶栓治疗的急性缺血性卒中患者224例,按是否合并早期神经功能恶化分为进展组(n=37例)和非进展组(n=187),经单因素及多因素logistic回归分析,分析影响早期神经功能恶化的危险因素。结果 经多因素logistic回归分析,发现年龄、糖尿病、NIHSS评分、白细胞计数、吞咽障碍、昏迷、心源性脑梗死是诱发早期神经功能恶化的独立危险因素。结论 诱发溶栓后早期神经功能恶化的危险因素较多,溶栓前加强相关检查,同时治疗期间密切观察患者病情变化,从而缓解病情进展。

Objective To investigate the risk factors of early neurological deterioration after intravenous thrombolysis by alteplase for patients with acute ischemic stroke.Methods A total of 224 patients with acute ischemic stroke treated with intravenous thrombolysis by alteplase and enrolled in our hospital from July,2016 to August,2018 were selected and divided into a progression group(n=37)and a non-progression group(n=187)according to whether or not complicated with early neurological deterioration.The risk factors of early neurological deterioration were analyzed by single factor and multivariate logistic regression analysis,and by univariate and multivariate Logistic regression analysis.Results Multivariate logistic regression analysis showed that age,diabetes,NIHSS score,white blood cell count,dysphagia,coma,and cardiogenic cerebral infarction were independent risk factors for early neurological deterioration.Conclusions There are many risk factors for early neurological deterioration after thrombolytic therapy.The related examinations should be strengthened before thrombolysis and the patients'conditions should be closely observed during the treatment so as to relieve the disease progression.