阿托伐他汀钙联合rt-PA静脉溶栓治疗脑梗死的疗效及预后多因素分析

The efficacy of atorvastatin calcium combined with rt-PA intravenous thrombolysis in the treatment of cerebral infarction and multivariate analysis of prognosis

目的观察阿托伐他汀钙联合重组人组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗脑梗死的疗效,分析影响脑梗死预后的因素。方法我院收治的172例脑梗死患者,均接受阿托伐他汀钙+rt-PA静脉溶栓治疗,评估患者神经功能缺损(NIHSS评分)及预后(mRS评分),并分析影响预后的因素。结果治疗前后患者NIHSS评分比较差异有统计学意义(P<0.05),患者治疗总好转率为90.12%;172例脑梗死患者中预后不良者占40.12%,预后良好者占59.88%;预后良好组和预后不良组吸烟史、脑梗死体积、治疗后收缩压、发病至治疗起始时间、溶栓前NIHSS评分比较,差异有统计学意义(P<0.05),脑梗死体积、治疗后收缩压、发病至治疗起始时间、溶栓前NIHSS评分是影响阿托伐他汀钙联合rt-PA静脉溶栓治疗脑梗死预后的危险因素(P<0.05)。结论阿托伐他汀钙联合rt-PA静脉溶栓治疗脑梗死疗效明确,可有效缓解患者神经功能缺损,改善预后,患者脑梗死体积、治疗后收缩压、发病至治疗起始时间、溶栓前NIHSS评分可能是影响阿托伐他汀钙联合rt-PA静脉溶栓治疗脑梗死预后的危险因素。

Objective To observe the efficacy of atorvastatin calcium combined with recombinant human tissue plasminogen activator(rt-PA)in the treatment of cerebral infarction,and to analyze the multi-factors affecting the prognosis of cerebral infarction.Methods Clinical data of 172 patients with cerebral infarction admitted to our hospital were retrospectively analyzed.Patients were treated with atorvastatin calcium+rt-PA intravenous thrombolytic therapy.The neurological deficit(NIHSS score)and prognosis(mRS score)were evaluated,and the factors affecting the prognosis were analyzed.Results There was a statistically significant difference in the NIHSS score before and after treatment(P<0.05),and the total improvement rate was 90.12%.Among the 172 patients,there were40.12%patients with poor prognosis and 59.88%patients with good prognosis.Smoking history,cerebral infarction volume,systolic blood pressure after treatment,time from onset to treatment initiation and NIHSS score before thrombolysis were single factors affecting the prognosis of cerebral infarction treated by this therapy(P<0.05).Cerebral infarction volume,systolic blood pressure after treatment,time from onset to treatment initiation and NIHSS score before thrombolysis were the risk factors affecting the prognosis of cerebral infarction treated by the therapy(P<0.05).Conclusion Atorvastatin calcium combined with rt-PA intravenous thrombolysis has exact efficacy in the treatment of cerebral infarction,and it can effectively alleviate the neurological deficits and improve the prognosis.Cerebral infarction volume,systolic blood pressure after treatment,time from onset to treatment initiation and NIHSS score before thrombolysis are risk factors for the prognosis of cerebral infarction treated by this therapy.