急性脑梗死静脉溶栓患者发生预后不良的影响因素

Influencing factors of poor prognosis in patients with acute cerebral infarction after intravenous thrombolysis

目的:分析急性脑梗死静脉溶栓患者发生预后不良的影响因素。方法:选取2020年3月至2022年7月该院收治的98例急性脑梗死患者进行前瞻性研究,溶栓后随访3个月,根据改良Rankin量表评分(mRS)将其分为预后良好组78例(mRS评分0~2分)与预后不良组20例(mRS评分>2分),采用Logistic回归分析急性脑梗死静脉溶栓患者发生预后不良的影响因素。结果:预后不良组合并糖尿病、溶栓前美国国立卫生研究院卒中量表(NIHSS)评分≥20分、发病至溶栓时间≥3.2 h、血尿酸<330μmol/L、正五聚蛋白3(PTX3)≥12 ng/mL、胶质纤维酸性蛋白(GFAP)>2 ng/L、陷窝蛋白-1(Cav-1)≥18μg/L、胆碱酯酶(CHE)<8067.67 U/L占比均高于预后良好组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,合并糖尿病、溶栓前NIHSS评分≥20分、发病至溶栓时间≥3.2 h、血尿酸<330μmol/L、PTX3≥12 ng/mL、GFAP>2 ng/L、Cav-1≥18μg/L、CHE<8067.67 U/L均为急性脑梗死静脉溶栓患者发生预后不良的危险因素(OR>1,P<0.05)。结论:合并糖尿病、溶栓前NIHSS评分≥20分、发病至溶栓时间≥3.2 h、血尿酸<330μmol/L、PTX3≥12 ng/mL、GFAP>2 ng/L、Cav-1≥18μg/L、CHE<8067.67 U/L均为急性脑梗死静脉溶栓患者发生预后不良的危险因素。

Objective:To analyze influencing factors of poor prognosis in patients with acute cerebral infarction after intravenous thrombolysis.Methods:A prospective study was conducted on 98 patients with acute cerebral infarction admitted to this hospital from March 2020 to July 2022.These patients were followed up for 3 months after thrombolysis.According to the modified Rankin scale score(mRS),they were divided into good prognosis group(n=78,mRS score 0-2)and poor prognosis group(n=20,mRS score>2).Logistic regression was used to analyze the influencing factors of poor prognosis in the patients with acute cerebral infarction after intravenous thrombolysis.Results:The proportions of Diabetes,NIHSS score before thrombolysis≥20,onset to thrombolysis time≥3.2 h,blood uric acid<330μmol/L,pentameric protein 3(PTX3)≥12 ng/mL,glial fibrillary acidic protein(GFAP)>2 ng/L,caveolin-1(Cav-1)≥18μg/L,cholinesterase(CHE)<8067.67 U/L in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that diabetes mellitus,NIHSS score before thrombolysis≥20,onset to thrombolysis time≥3.2 h,blood uric acid<330μmol/L,pentameric protein 3(PTX3)≥12 ng/mL,glial fibrillary acidic protein(GFAP)>2 ng/L,caveolin-1(Cav-1)≥18μg/L,cholinesterase(CHE)<8067.67 U/L were all risk factors for poor prognosis in the patients with acute cerebral infarction undergoing intravenous thrombolysis.Conclusions:Diabetes mellitus,NIHSS score before thrombolysis≥20,onset to thrombolysis time≥3.2 h,blood uric acid<330μmol/L,pentameric protein 3(PTX3)≥12 ng/mL,glial fibrillary acidic protein(GFAP)>2 ng/L,caveolin-1(Cav-1)≥18μg/L,cholinesterase(CHE)<8067.67 U/L are the risk factors for poor prognosis in patients with acute cerebral infarction undergoing intravenous thrombolysis.