低钾血症和低钠血症对急性缺血性脑卒中溶栓患者短期预后的影响

Effect of hypokalemia and hyponatremia on short-term prognosis in patients with acute ischemic stroke

目的研究低钾血症和低钠血症对急性缺血性脑卒中溶栓患者短期预后的影响。方法选取2018年11月~2019年5月于抚顺市中心医院收治的住院并且接受静脉溶栓治疗的患者共108例,其中急性缺血性脑卒中患者(45例),急性缺血性脑卒中伴低钠血症患者(36例),急性缺血性脑卒中伴低钾血症(27例),比较三组患者溶栓前,溶栓后24 h、3 d的美国国立卫生研究院卒中量表(NIHSS)评分,溶栓后14 d改良Rankin量表(mRs)评分及出血转化率是否有差异。再将低钾血症组分为A组(轻度低钾)、B组(中度低钾)、C组(重度低钾),低钠血症组分为a组(轻度低钠)、b组(中度低钠)、c组(重度低钠),分别比较各组间溶栓前,溶栓后24 h、3 d的NIHSS评分,溶栓后14 d mRs评分是否有差异。结果三组患者溶栓前NIHSS评分不存在显著差异(P>0.05),三组患者溶栓后24 h、3 d的NIHSS评分及14 d后mRs评分均有所下降,其中伴有低钠血症的溶栓患者下降幅度不如其他两组,差异有统计学意义(P<0.05),出血转化率三组不存在显著差异(P>0.05)。A、B、C三组在溶栓前,溶栓后24 h,3 d的NIHSS评分,溶栓后14 d mRs评分上差异均无统计学意义(P>0.05)。a、b、c三组比较,溶栓后24 h、3 d的NIHSS评分,溶栓后14 d mRs评分差异存在统计学意义(P<0.05)。结论低钠血症对急性缺血性脑卒中溶栓患者短期预后存在不良影响,且血钠浓度越低,影响越大。

Objective To study the effects of hypokalemia and hyponatremia on the short-term prognosis of patients with acute ischemic stroke.Methods A total of 108 patients who were admitted to Fushun Central Hospital and received intravenous thrombolysis from November 2018 to May 2019 were selected,including acute ischemic stroke patients(45 cases)and acute ischemic brain.Patients with stroke with hyponatremia(36 cases)and acute ischemic stroke with hypokalemia(27 cases).The three groups of patients were compared with the NIHSS score before thrombolysis,24 hours after thrombolysis,and 3 days after thrombolysis.Are there differences in mRs scores and bleeding conversion rates at 14 days?The hypokalemia component was group A(mild hypokalemia),group B(moderate hypokalemia),and group C(severe hypokalemia),and the hyponatremia component was group a(mild hyponatremia).Groups B,B(moderately low sodium),and C(severe low sodium),compared the NIHSS scores before thrombolysis,24 hours after thrombolysis,and 3 days,and whether there were differences in mRs scores 14 days after thrombolysis.Results There was no significant difference in the NIHSS scores before thrombolysis in the three groups(P>0.05).The NIHSS scores of the three groups decreased after 24 hours,3 days,and the mRs scores after 14 days,with hyponatremia.The decline in thrombolytic patients was not as good as the other two groups,and the difference was statistically significant(P<0.05).There was no significant difference in bleeding conversion rates among the three groups(P>0.05).There were no significant differences in the NIHSS scores before thrombolysis,24 hours after thrombolysis,and 3 days,and the mRs scores at 14 days after thrombolysis(P>0.05).Comparing the three groups a,b,and c,there were significant differences in NIHSS scores at 24 hours and 3 days after thrombolysis,and mRs scores at 14 days after thrombolysis(P<0.05).Conclusion Hyponatremia is associated with acute ischemic stroke The short-term prognosis of thrombolytic patients has adverse effects,and the lower the blood sodium concentration,the greater the impact.