急性脑梗死rt-PA溶栓后并发脑水肿相关危险因素分析

Analysis of risk factors associated with cerebral edema after thrombolysis treatment with rt-PA in patients with acute cerebral infarction

目的:探讨急性脑梗死患者接受重组组织型纤溶酶原激活物(rt-PA)溶栓治疗后血管再通发生脑水肿的危险因素。方法:选择我科急诊收治急性脑梗死使用rt-PA治疗血管再通患者112例,根据脑水肿发生情况分为发生组76例和不发生组36例,分析影响疗效因素。结果:2组糖尿病例数、NIHSS评分、梗死动脉侧支循环建立例数及脑梗死面积对比差异均有统计学意义(P<0.05);Logistic回归分析证明,合并糖尿病、NIHSS评分较高、梗死动脉侧支循环建立较少及脑梗死面积较大是急性脑梗死患者溶栓治疗后并发脑水肿及脑组织缺失的预测指标。结论:急性脑梗死患者接受rt-PA溶栓治疗,若合并糖尿病、NIHSS评分较高、梗死动脉侧支循环建立较少及脑梗死面积较大,发生脑水肿及脑组织缺失的风险较高,需尽早积极处理。

Objective:To evaluate the risk factors associated with brain edema induced by vessel recanalization after thrombolysis treatment with recombinant tissue-type plasminogen activator(rt-PA) in patients with acute cerebral infarction. Methods:A total of 112 patients with acute cerebral infarction who accepted rt-PA treatment in our department were selected and were divided into edema group(n = 76) and no-edema group(n = 36). Influencing factors of curative effect were analyzed. Results:There were significant differences in the case numbers of diabetes,NIHSS score,numbers of infarction artery with collateral circulation and volume of cerebral infarction between the two groups(P < 0. 05). Logistic regression analysis showed that combination with diabetes,high NIHSS score,few infarction arteries with collateral circulation and large area of cerebral infartion were predicton factors of cerebral edema and loss in patients with acute cerebral infarction after thrombolysis treatment with rt-PA. Conclusion:Combination with diabetes,high NIHSS score,few infarction arteries with collateral circulation and large area of cerebral infartion are risk factors of cerebral edema and loss in patients with acute cerebral infarction after thrombolysis treatment with rt-PA.