老年急性脑梗死患者静脉溶栓后发生早期神经功能恶化的影响因素分析

Influencing Factors of Early Neurological Deterioration in Elderly Patients with Acute Cerebral Infarction after Intravenous Thrombolysis

目的探讨老年急性脑梗死(ACI)患者静脉溶栓后发生早期神经功能恶化(END)的影响因素。方法以100例老年ACI患者为对象,依据患者溶栓后NIHSS评分值将患者的为END组(n=17)和非END组(n=83)。收集患者一般资料,分析影响溶栓后END的危险因素。结果单因素分析显示END组与非END组在性别、高血压、高脂血症、心肌梗死、吸烟、饮酒、血小板计数(PLT)、血红蛋白(Hb)、发病之溶栓时间、梗死部位方面比较无差异(P>0.05);两组年龄、糖尿病、美国国立卫生研究院卒中量表(NIHSS)评分、白细胞计数(WBC)、TOAST分型比较差异显著(P<0.05)。Logistic回归分析,结果显示年龄(OR=1.894)、糖尿病(OR=1.426)、NIHSS评分(OR=1.281)、WBC(OR=1.263)、TOAST分型(OR=3.271)为ACI患者溶栓后并发END的危险因素(P<0.05)。结论高龄、高NIHSS评分、高WBC及糖尿病为老年ACI患者溶栓后并发END的危险因素。

Objective To investigate the influencing factors of early neurological deterioration(end)in elderly patients with acute cerebral infarction(ACI)after intravenous thrombolysis.Methods 100 elderly patients with ACI were divided into end group(n=17)and non end group(n=83)according to the NIHSS score after thrombolysis.The general data of patients were collected and the risk factors of end after thrombolysis were analyzed.Results The univariate analysis showed that there was no significant difference in gender,hypertension,hyperlipidemia,myocardial infarction,smoking,drinking,platelet count(PLT),hemoglobin(HB),thrombolytic time and infarct location between end group and non end group(P>0.05);There were significant differences between the two groups in age,diabetes,National Institutes of Health Stroke Scale(NIHSS),white blood cell count(WBC)and TOAST typing(P<0.05).Logistic regression analysis showed that age(OR=1.894),diabetes mellitus(OR=1.426),NIHSS score(OR=1.281),WBC(OR=1.263)and TOAST classification(OR=3.271)were risk factors for END in ACI patients after thrombolysis.Conclusion Age,high NIHSS score,high WBC and diabetes are risk factors for END in elderly ACI patients after thrombolysis.