摘要
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.
作者
崔亚魁
CUI Yakui(Department of Clinical Laboratory of Yongcheng Central Hospital,Yongcheng 476600 Henan,China)
出处
《中国民康医学》
2023年第18期8-11,共4页
Medical Journal of Chinese People’s Health
关键词
急性脑梗死
静脉溶栓
预后不良
影响因素
Acute cerebral infarction
Intravenous thrombolysis
Poor prognosis
Influencing factor