摘要
目的研究重组组织型纤溶酶原激活剂(rt PA)静脉溶栓治疗发病4.5 h内的老年急性脑梗死患者转归不良的危险因素。方法选取75例发病4.5 h内的缺血性脑卒中行rt PA静脉溶栓治疗的老年患者,分为转归不良及转归良好组,分析影响转归的危险因素,对各项指标进行单因素Logistic回归分析,对有统计学意义的因素行多元Logistic回归分析。结果年龄大、糖尿病、心房颤动、溶栓前收缩压高、空腹血糖高、低密度脂蛋白胆固醇高、血同型半胱氨酸高、心源性栓塞、血糖控制不佳、溶栓后2 h NIHSS评分降低少等因素在转归良好与不良组间差异显著(P<0.05),是溶栓后转归不良的危险因素;多元Logistic回归分析显示房颤(OR 1.03,95%CI 1.002~1.049,P=0.032)、基线高空腹血糖(OR 2.15,95%CI0.864~2.025,P=0.045)是转归不良的独立危险因素。结论 4.5 h内缺血性脑卒中rt PA静脉溶栓患者转归不良的独立危险因素为房颤、高血糖。
Objective To analyze the poor prognosis factors of intravenous thrombolysis with recombinant tissue -type plasminogen activator (rtPA) within 4.5 h of acute cerebral infarction(ACI).Methods 75 subjects who were given intravenous thrombolysis with rtPA within 4.5 h of ischemic stroke were divided into two groups according to the prognosis profile .The predictors of prognosis were evaluated with univariate analysis and logistic regression analysis .Results Older age, diabetes mellitus, atrial fibrillation, higher systolic blood pres-sure before thrombolysis , elevated fasting plasma glucose concentration , higher low-density lipoprotein cholesterol level , hyperhomocyctine-mia, cardiogenic embolism, suboptimal plasma glucose control were associated with poor prognosis (P<0.05).Multivariate logistic regres-sion analysis further showed that cardiac embolism (OR 1.03, 95%CI 1.002~1.049, P=0.032) and hyperglycemia (OR 2.15, 95%CI 0.864~2.025, P=0.045) were independent risk factors of poor prognosis .Conclusions 4.5 h of ischemic stroke, cardiac embolism and blood glucose are independent predictors of poor prognosis .
出处
《中国老年学杂志》
CAS
CSCD
北大核心
2014年第23期6549-6551,共3页
Chinese Journal of Gerontology
基金
国家自然科学基金(No.80905044)
国家"十一五"科技支撑计划(No.2010BAI10B07)
关键词
静脉溶栓
缺血性脑卒中
重组组织型纤溶酶原激活剂
Intravenous thrombolysis
Ischemic stroke
Recombinant tissue-type plasminogen activator
