急性前循环脑梗死rt-PA静脉溶栓患者TIBI分级和血管再通、神经功能及短期预后的关系

Relationship between TIBI classification,vascular recanalization,neurological function and short-term prognosis in patients with acute anterior circulation cerebral infarction treated with rt-PA intravenous thrombolysis

目的探讨急性前循环脑梗死重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓患者的脑缺血溶栓血流分级(TIBI)与血管再通、神经功能及短期预后的关系。方法选择安徽皖北煤电集团总医院2018年7月—2019年12月接受静脉溶栓的102例急性前循环脑梗死患者为研究对象。所有患者均行rt-PA静脉溶栓治疗,根据治疗后改良Rankin量表(mRS)得分将患者分为预后良好组(44例)和预后不良组(58例)。比较两组临床基线资料;多因素分析采用logistic回归分析,相关性分析采用Pearson相关系数分析。结果预后良好组年龄、美国国立卫生研究院卒中量表(NIHSS)评分低于预后不良组(P<0.05);预后良好组TIBI分级和血管总再通率高于预后不良组(P<0.05)。TIBI分级、血管总再通率和NIHSS评分是影响患者短期预后的独立危险因素(OR>1,P<0.05)。mRS评分与NIHSS评分呈正相关(r=0.278,P<0.01),mRS评分与TIBI分级、血管总再通率呈负相关(r=-0.527、-0.372,P<0.01)。结论急性前循环脑梗死rt-PA静脉溶栓患者的TIBI分级、血管再通率和NIHSS评分是影响患者治疗后短期预后的独立危险因素。患者的mRS评分与NIHSS评分呈正相关,而与TIBI分级和血管再通率呈负相关。

Objective To study the relationship between TIBI classification,vascular recanalization,neurological function and short-term prognosis in patients with acute anterior circulation cerebral infarction treated with recombinant tissue-type plasminogen activator(rt-PA)intravenous thrombolysis.Methods A total of 102 patients with acute anterior circulation cerebral infarction who received intravenous thrombolysis from July 2018 to December 2019 in Anhui Wanbei Coal-Electricity Group General Hospital were selected as study objects.All patients were treated with rt-PA intravenous thrombolysis,and the patients were divided into good prognosis group(44 cases)and poor prognosis group(58 cases)according to the modified Rankin scale(mRS)score after treatment.The clinical baseline data were compared;logistic regression analysis was used for multivariate analysis,and Pearson correlation coefficient analysis was used for correlation analysis.Results Age and national institutes of health stoke scale(NIHSS)score of good prognosis group were lower than those of poor prognosis group,and the differences were statistically significant(P<0.05).TIBI grade and total vascular recanalization rate in good prognosis group were higher than those in poor prognosis group(P<0.05).TIBI grade,total vascular recanalization rate and NIHSS score were independent risk factors for short-term prognosis(OR>1,P<0.05).There was a positive correlation between mRS score and NIHSS score(r=0.278,P<0.01),and a negative correlation between mRS score and TIBI grade and total vascular recanalization rate(r=-0.527,-0.372,P<0.01).Conclusion The TIBI classification,vascular recanalization rate and NIHSS score of patients with acute anterior circulation cerebral infarction rt-PA intravenous thrombolysis are independent risk factors that affect the short-term prognosis of patients after treatment,and the patient’s mRS score was positively correlated with NIHSS score,but negatively correlated with TIBI grade and vascular recanalization rate.