256例ACI患者溶栓后早期神经功能恶化高危因素

Risk Factors for Early Neurological Deterioration after Thrombolysis in 256 ACI Patients

目的:分析急性脑梗死(ACI)溶栓后早期神经功能恶化(END)的高危因素,旨在指导临床完善干预策略,改善预后。方法:选取福建医科大学附属第一医院2018年1月-2021年12月收治的256例ACI患者,4.5 h内给予静脉溶栓。记录溶栓后END发生情况,据此分为END组、非END组。Logistic回归ACI患者溶栓后END的影响因素。结果:256例ACI患者溶栓后END发生率为20.70%;END组收缩压、心房颤动史、糖尿病、基线美国国立卫生研究院卒中量表评分(NIHSS)、血清脂蛋白(a)[LP(a)]、白蛋白(ALB)水平与非END组对比,差异有统计学意义(P<0.05);Logistic回归分析表明,ACI患者溶栓后END与收缩压、心房颤动、糖尿病、基线NIHSS评分及血清LP(a)、ALB水平有关(P<0.05)。结论:ACI溶栓后仍具有较高END风险,收缩压、心房颤动、糖尿病、基线NIHSS评分、血清LP(a)、ALB水平是其END的重要影响因素。

Objective:To analyze the high-risk factors of early neurological deterioration(END)after thrombolysis in acute cerebral infarction(ACI),in order to guide clinical improvement of intervention strategies and improve prognosis.Method:A total of 256 patients with ACI in the First Affiliated Hospital of Fujian Medical University from January 2018 to December 2021 were selected and given intravenous thrombolysis within 4.5 hours.The occurrence of END after thrombolysis was recorded,and the patients were divided into END group and non-END group accordingly.Logistic regression was used to analyze the influencing factors of END after thrombolysis in ACI patients.Result:The incidence of END after thrombolysis in 256 ACI patients was 20.70%.The systolic blood pressure,history of atrial fibrillation,diabetes,baseline National Institute of Health stroke scale(NIHSS)score,serum lipoprotein(a)[LP(a)]and albumin(ALB)levels in the END group compared with the non-END group,the differences were statistically significant(P<0.05).Logistic regression analysis showed that END after thrombolysis in ACI patients was associated with systolic blood pressure,atrial fibrillation,diabetes,baseline NIHSS score,serum LP(a)and ALB levels(P<0.05).Conclusion:ACI still has a high risk of END after thrombolysis.The systolic blood pressure,atrial fibrillation,diabetes,baseline NIHSS score,serum LP(a)and ALB levels are important influencing factors for END.