急性脑梗死患者溶栓疗效的影响因素研究

Study on the Influencing Factors of Thrombolytic Therapy Efficacy in Patients with Acute Cerebral Infarction

【目的】探讨急性脑梗死(ACI)患者溶栓疗效的影响因素。【方法】回顾性分析本院收治的120例ACI溶栓治疗患者的临床资料。根据患者溶栓疗效分为良好组和不良组,比较两组患者相关资料的差异,采用多因素Logistic回归分析法分析影响ACI患者溶栓效果的独立危险因素。【结果】120例经溶栓治疗的ACI患者有34例(28.33%)预后不良,纳为不良组;其余86例(71.67%)预后良好,纳为良好组。两组患者的体重指数(BMI)、发病至溶栓时间、发病至首次经颅多普勒超声(TCD)检查时间、血脂和凝血指标水平、性别及合并疾病构成比比较,差异均无统计学意义(P>0.05);不良组患者年龄、美国国立卫生研究院卒中量表(NIHSS)评分均高于良好组(P<0.05),TCD评估血管脑缺血溶栓血流(TIBI)分级、血管再通率均低于良好组(P<0.05)。多因素Logistic回归分析显示,TIBI分级(OR=2.658)、血管再通率(OR=6.532)、NIHSS评分(OR=8.712)是影响ACI患者溶栓治疗后疗效的独立危险因素(P<0.05)。【结论】TIBI分级、血管再通率、NIHSS评分是ACI患者溶栓治疗预后不良的影响因素。

【Objective】To investigate the factors affecting the efficacy of thrombolytic therapy in patients with Acute Cerebral Infarction(ACI).【Methods】A retrospective analysis was conducted on the clinical data of 120 patients with ACI who underwent thrombolytic therapy in our hospital.Based on the therapeutic effect of thrombolysis,patients were divided into a good prognosis group and a poor prognosis group.Differences in relevant data between the two groups were compared,and multivariate logistic regression analysis was used to analyze the independent risk factors affecting the thrombolytic effect in ACI patients.【Results】Out of the 120 ACI patients treated with thrombolysis,34 cases(28.33%)had poor prognosis and were categorized into the poor group;the remaining 86 cases(71.67%)had good prognosis and were categorized into the good group.There were no significant differences between the two groups in terms of Body Mass Index(BMI),time from onset to thrombolysis,time from onset to the first Transcranial Doppler(TCD)examination,blood lipid and coagulation index levels,gender,and comorbidities(P>0.05).The age and National Institutes of Health Stroke Scale(NIHSS)scores in the poor prognosis group were higher than those in the good prognosis group(P<0.05),while the Thrombolysis in Brain Ischemia(TIBI)grading and vascular recanalization rate in the poor prognosis group were lower than those in the good prognosis group(P<0.05).Multivariate logistic regression analysis showed that TIBI grading(OR=2.658),vascular recanalization rate(OR=6.532),and NIHSS score(OR=8.712)were independent risk factors affecting the efficacy of thrombolytic therapy in ACI patients(P<0.05).【Conclusion】TIBI grading,vascular recanalization rate,and NIHSS score are risk factors for poor prognosis in patients with ACI undergoing thrombolytic therapy.