脑梗死尿激酶静脉溶栓治疗的性别差异及相关因素分析

Gender Differences and Related Factors of Intravenous Thrombolytic Therapy with Urokinase in Cerebral Infarction

目的探讨脑梗死患者尿激酶静脉溶栓治疗的性别差异及其相关影响因素。方法选取2017年5月~2018年5月白城中心医院神经内科急性缺血性脑卒中发病6 h内符合静脉溶栓条件,完成尿激酶静脉溶栓的病例92例,按性别分组。回顾分析其不同性别之间基线危险因素,溶栓并发症及溶栓10~14 d内神经功能康复的差异。结果男女基线危险因素中饮酒史、吸烟史、缺血性卒中或短暂性脑缺血发作(TIA)史、高同型半胱氨酸血症,男性组均高于女性组,差异有统计学意义(P <0.05);两组在高血压史、糖尿病史、血脂异常、脑出血史、外周血管病、高尿酸血症、高纤维蛋白原血症方面差异均无统计学意义(P> 0.05)。男女组溶栓后出现心血管事件、肺炎、脑出血、消化道出血、卒中再发等并发症,差异均无统计学意义(P> 0.05);出院时美国国立卫生研究院卒中量表(NIHSS)评分及Barthel指数(BI)评分比较差异均无统计学意义(P> 0.05)。结论脑梗死患者在饮酒吸烟史、缺血性卒中或TIA史、高同型半胱氨酸血症方面,不同性别比较有显著差异,在临床治疗中应加强对男性患者的管理,做好脑卒中一级和二级预防。

Objective To investigate gender differences and related factors of intravenous thrombolytic therapy with urokinase in cerebral infarction.Methods 92 patients who met the thrombolytic criteria after the onset of acute ischemic stroke and received the intravenous thrombolysis with urokinase were enrolled from May 2017 to May 2018 in Baicheng Central Hospital.The patients were grouped according to the gender.Baseline risk factors,thrombolytic complications and neurological function within 10-14 days after thrombolysis were analyzed retrospectively.Results The proportions of patients with alcohol consumption,smoking history,ischemic stroke or transient cerebral ischemia(TIA)history,hyperhomocysteinemia were higher in male group than those in female group(P<0.05).There were no significant differences in the history of hypertension,diabetes,dyslipidemia,cerebral hemorrhage,peripheral vascular disease,hyperuricemia and hyperfibrinogenemia(P>0.05).There were no significant differences in cardiovascular events,pneumonia,cerebral hemorrhage,gastrointestinal bleeding,and recurrent stroke after thrombolysis between male group and female group(P>0.05).There were no significant differences the scores of in national institutes of health stroke scale(NIHSS)and Barthel index(BI)at discharge between male group and female group(P>0.05).Conclusion There are significant differences in the history of alcohol consumption,smoking,ischemic stroke,TIA and hyperhomocysteinemia between male and female patients with cerebral infarction.The management of male patients with cerebral infarction,and primary and secondary prevention of stroke should be strengthened in clinical treatment.