阿替普酶静脉溶栓治疗急性脑梗死血管再闭塞的影响因素

Analysis of prognostic after intravenous thrombolysis with alteplase in acute cerebral infarction

目的探讨急性脑梗死静脉溶栓治疗的血管再闭塞情况及其危险因素。方法回顾性选取急性脑梗死静脉溶栓患者资料,观察年龄、性别、心房颤动史、高血压史、高脂血症、既往脑卒中史、吸烟史、糖尿病病史、血糖、收缩压、美国国立卫生研究院脑卒中量表(NIHSS)评分、起病-溶栓时间等指标与再闭塞的关系。结果再闭塞组与无再闭塞组年龄、性别、心房颤动史、高血压史、高脂血症、既往脑卒中史、吸烟史无显著差异(P>0. 05);糖尿病病史、血糖、收缩压、NIHSS评分、起病-溶栓时间差异具有显著性(P<0. 05)。Logistic回归分析显示:糖尿病病史、血糖、收缩压、NIHSS评分、起病-溶栓时间与再闭塞显著相关。结论糖尿病病史、血糖、收缩压、NIHSS评分、起病-溶栓时间是再闭塞的独立危险因素。

Objective To investigate the association between no recanalization and recanalization of acute cerebral infarction patients of intravenous thrombolysis after intravenous thrombolysis with alteplase.Methods The indexes of patients with acute cerebral infarction who underwent intravenous thrombolysis were collected,such as age,sex and history of hypertension,diabetes mellitus,smoking,and the levels of systolic pressure,blood glucose,NIHSS score and onset-thrombolysis time.Results There were no significant differences in age,sex,atrial fibrillation,history of hypertension ateral between the two groups(P>0.05).There were significant differences in history of diabetes mellitus,smoking,and the levels of systolic pressure,blood glucose,NIHSS score and onset-thrombolysis time between the two groups(P<0.05).The Logistic regression analysis showed that diabetes(OR=4.02,P=0.036),systolic pressure(OR=10.86,P=0.001),blood glucose(OR=10.26,P=0.026),NIHSS score(OR=1.29,P=0.001),and onset-thrombolysis time(OR=1.04,P=0.042)were significantly associated with no recanalization.Conclusions The history of diabetes,the levels of systolic pressure,blood glucose,NIHSS score and onset-thrombolysis time are independent risk factors of no recanalization in patients of intravenous thrombolysis after intravenous thrombolysis with alteplase.