急性脑梗死尿激酶静脉溶栓后24 h内缺血加重的影响因素分析

目的探讨急性脑梗死经尿激酶静脉溶栓后24 h内缺血加重的影响因素。方法纳入119例经尿激酶静脉溶栓的急性脑梗死患者进行回顾性队列研究,根据24 h内是否出现缺血加重,分为加重组(NIHSS评分增加≥2分)26例及非加重组93例,比较2组临床资料,采用Logistic回归分析24 h内缺血加重的影响因素。结果单因素Logistic回归分析发现,责任血管中重度狭窄/闭塞、溶栓前高NIHSS评分是影响缺血加重的危险因素(均P<0.05)。多因素Logistic回归分析显示,男性(OR=6.224,95%CI=1.303~29.921,P=0.022)、责任血管中重度狭窄/闭塞(OR=6.326,95%CI=1.910~20.947,P=0.003)是尿激酶静脉溶栓后24 h内缺血加重的危险因素。结论尿激酶静脉溶栓后24 h内早期缺血加重多见于男性及大动脉粥样硬化型的脑梗死患者。

Influencing factors of ischemic deterioration within 24 hours after intravenous thrombolysis with urokinase in acute cerebral infarction

Objective To explore the influencing factors of ischemic deterioration within 24 hours after intravenous thrombolysis with urokinase in acute cerebral infarction.Methods 119 patients treated by intravenous thrombolysis with urokinase were enrolled in a retrospective cohort study.According to whether ischemic deterioration within 24 hours,they were divided into deteriorating group(NIHSS score increased more than 2 points)26 cases and non-deteriorating group 93 cases.The clinical data of the two groups were compared and the influencing factors of ischemic deterioration within 24 hours were analyzed by Logistic regression.Results Univariate Logistic regression analysis showed that moderate to severe stenosis/occlusion of responsible arteries and high NIHSS score before thrombolysis were risk factors for ischemic deterioration(both P<0.05).Multivariate Logistic regression analysis showed that male(OR=6.224,95%CI=1.303-29.921,P=0.022),moderate or severe stenosis/occlusion of responsible arteries(OR=6.326,95%CI=1.910-20.947,P=0.003)were risk factors for ischemic deterioration within 24 hours after intravenous thrombolysis with urokinase.Conclusion Early ischemic deterioration within 24 hours after intravenous thrombolysis with urokinase is more common in male and large artery atherosclerotic cerebral infarction patients.