急性缺血性脑卒中患者静脉溶栓治疗后早期神经功能恶化的影响因素

The influence factors of early neurological deterioration after intravenous thrombolytic therapy in patients with acute ischemic stroke

目的分析急性缺血性脑卒中(AIS)患者静脉溶栓治疗后早期神经功能恶化(END)的影响因素。方法回顾性分析2020年1—8月贵港市人民医院收治的91例采用静脉溶栓治疗的AIS患者的临床资料,根据溶栓后24 h内是否发生END,分为恶化组29例及非恶化组62例,采用多因素logistic回归分析END的影响因素。结果单因素分析显示,恶化组患者女性、发热、责任大动脉狭窄或闭塞、重组组织型纤溶酶原激活剂(rt-PA)溶栓等比例以及入院NIHSS评分、白细胞计数、随机血糖均高于非恶化组(P<0.05),而进一步多因素分析显示,性别、白细胞计数、随机血糖、责任大动脉狭窄或闭塞以及溶栓剂是AIS患者静脉溶栓治疗后END的影响因素。结论女性、治疗前白细胞计数及血糖偏高、有责任大动脉狭窄或闭塞以及使用rt-PA溶栓的AIS患者,较易发生溶栓后END。

Objective To analyze the influencing factors of early neurological deterioration(END)in patients with acute ischemic stroke(AIS)after intravenous thrombolytic therapy.Methods The clinical data of 91 AIS patients treated with intravenous thrombolytic therapy in Guigang City People’s Hospital from January to August 2020 were retrospectively analyzed.According to whether END occurred within 24 hours after thrombolytic therapy,they were divided into worsening group(n=29)and non-worsening group(n=62).Multivariate logostic regression was used to analyze the influencing factors of END.Results Univariate analysis showed that the proportion of female,fever,responsible artery stenosis or occlusion,recombinant tissue plasminogen activator(rt-PA)thrombolysis,admission NIHSS score,white blood cell count,and random blood glucose in the worsening group were higher than those in the non-worsening group(P<0.05).Further multivariate analysis showed that,Gender,white blood cell count,random blood glucose,arterial stenosis or occlusion,and thrombolytic agents are the influencing factors of END in AIS patients after intravenous thrombolytic therapy.Conclusion AIS patients with female,high white blood cell count and blood glucose before treatment,responsible arterial stenosis or occlusion,and thrombolytic therapy with RT-PA are more likely to develop END after thrombolytic therapy.