急性脑梗死患者rt–PA静脉溶栓好转后恶化发生的相关因素

Related Factors of Worsening after rt-PA Intravenous Thrombolysis in Patients with Acute Cerebral Infarction

目的:探讨急性脑梗死(ACI)患者重组组织型纤溶酶原激活剂(rt–PA)静脉溶栓好转后恶化的影响因素。方法:选取2018年12月至2019年12月在焦作市中医院接受rt–PA静脉溶栓治疗后好转的260例ACI患者,患者于rt–PA静脉溶栓好转后随访3个月,记录患者好转后恶化发生情况,并分为发生组和未发生组,记录患者的基线资料,将可能的影响因素纳入,分析影响ACI患者rt–PA静脉溶栓好转后恶化发生的因素。结果:260例ACI患者rt–PA静脉溶栓好转后发生恶化的有35例,发生率为13.46 %;发生组患者合并基础疾病的占比高于未发生组,溶栓时间长于未发生组,入院时的美国国立卫生院卒中量表(NIHSS)评分高于未发生组,白细胞计数(WBC)水平高于未发生组,差异均具有统计学意义(P<0.05);经logistic回归分析,结果显示,合并基础疾病、溶栓时间长、入院时NIHSS评分高、WBC水平高均是ACI患者rt–PA静脉溶栓好转后恶化的危险因素(P<0.05)。结论:合并基础疾病、溶栓时间长、入院时NIHSS评分高、WBC水平高是ACI患者rt–PA静脉溶栓好转后恶化发生的影响因素。

Objective To investigate the influencing factors of deterioration after improvement of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis in patients acute cerebral infarction (ACI).Methods A total of 260 ACI patients who were improved after rt-PA intravenous thrombolytic therapy were selected from December 2018 to December 2019 in Jiaozuo Hospital of Traditional Chinese Medicine.Patients were followed up for 3 months after rt-PA intravenous thrombolytic therapy.The incidence of deterioration after improvement was recorded,and the patients were divided into the occurrence group and the non-occurrence group.To analyze the factors affecting the occurrence of deterioration after improvement of rt-PA intravenous thrombolysis in ACI patients.Results Among 260 ACI patients,35 cases (13.46%) had deterioration after improvement of rt-PA intravenous thrombolysis.The proportion of patients with underlying diseases in the occurrence group was higher than that in the non-occurrence group,the thrombolysis time was longer than that in the non-occurrence group,the score of National Institutes of Health Stroke Scale (NIHSS) was higher than that in the non-occurrence group,and the level of white blood cell count (WBC) was higher than that in the non-occurrence group,the differences were statistically significant (P < 0.05).Logistic regression analysis showed that combined underlying diseases,long thrombolysis time,high NIHSS score at admission and high WBC level were all risk factors for deterioration after improvement of rt-PA intravenous thrombolysis in ACI patients (P < 0.05).Conclusion Combined basis diseases,long thrombolysis time,high NIHSS score at admission,and high WBC level are the influencing factors of the deterioration after improvement of rt-PA intravenous thrombolysis in ACI patients.