急性缺血性脑卒中患者溶栓后梗死核心体积动态分析及其相关因素分析

Dynamic analysis of infarct core volume and its related factors in patients with acute ischemic stroke after thrombolysis

目的动态分析急性缺血性脑卒中(Acute ischemic stroke,AIS)患者溶栓后梗死核心体积变化情况及其相关影响因素分析。方法纳入2020年1月-2023年1月本院106例静脉溶栓治疗的AIS患者为研究对象,所有患者均接受溶栓治疗,并分别记录患者基线时、溶栓后第24、48 h梗死核心体积;动态分析AIS患者溶栓后梗死核心体积变化情况;采用多变量线性模型分析AIS患者溶栓后梗死核心体积动态变化的相关影响因素。结果基线时患者梗死核心体积为21.31(16.98,40.20)mL;溶栓后第24 h患者梗死核心体积为35.42(14.19,47.72)mL;溶栓后第48 h患者梗死核心体积为44.05(14.01,63.23)mL。多重线性回归分析显示,溶栓后第24 h梗死核心体积变化与高血压病、发病至溶栓时间、收缩压、舒张压、动脉闭塞病灶量表(Arterial occlusive lesion,AOL)等级有关(P<0.05);溶栓后第48 h梗死核心体积变化与高血压病、发病至溶栓时间、美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分、AOL等级有关(P<0.05)。结论AIS患者梗死核心体积在溶栓后的48 h内呈上升趋势,且溶栓后第24 h梗死核心体积变化与高血压病、发病至溶栓时间、收缩压、舒张压、AOL等级有关;溶栓后第48 h梗死核心体积变化与高血压病、发病至溶栓时间、NIHSS评分、AOL等级有关。

Objective To dynamically analyze the changes of infarct core volume and its related influencing factors in patients with acute ischemic stroke(AIS)after thrombolysis.Methods 106 AIS patients treated with intravenous thrombolysis in our hospital from January 2020 to January 2023 were included as the research object.All patients received thrombolytic therapy,and the infarct core volume was recorded at baseline,24 hours after thrombolysis and 48 hours after thrombolysis,and the changes of infarct core volume in AIS patients after thrombolysis were dynamically analyzed.Multivariate linear model was used to analyze the related influencing factors of dynamic changes of infarct core volume in AIS patients after thrombolysis.Results The infarct core volume was 21.31(16.98,40.20)ml at baseline,35.42(14.19,47.72)ml at 24 hours after thrombolysis and 44.05(14.01,63.23)ml at 48 hours after thrombolysis.The results of multiple linear regression analysis showed that the change of infarct core volume at 24 hours after thrombolysis was related to hypertension,time from onset to thrombolysis,systolic blood pressure,diastolic blood pressure and AOL grade(P<0.05),and the change of infarct core volume at 48 hours after thrombolysis was related to hypertension,time from onset to thrombolysis,NIHSS score and AOL grade(P<0.05).Conclusion The infarct core volume of AIS patients showed an upward trend within 48 hours after thrombolysis,and the change of infarct core volume at 24 hours after thrombolysis was related to hypertension,time from onset to thrombolysis,systolic blood pressure,diastolic blood pressure and AOL grade,and the change of infarct core volume at 48 hours after thrombolysis was related to hypertension,time from onset to thrombolysis,NIHSS score and AOL grade.