阿替普酶静脉溶栓治疗缺血性脑卒中 112例的预后影响因素分析

目的探讨阿替普酶静脉溶栓治疗急性缺血性脑卒中病人 90 d后预后的相关影响因素。方法纳入 2016年 1月至 2019年 1月在上海市第六人民医院金山分院诊断为急性缺血性脑卒中并进行静脉阿替普酶溶栓的病人，收集病人的基线资料，测定溶栓后 90 d病人改良 Rankin量表( modified Rankin scale，mRS)评分，将病人分为预后良好组( 0~2分)与预后不良组(3~6分)。采用二元 logistic回归分析不良预后的影响因素。结果共纳入病人 112例。其中，男 66例( 58.93%)，女 46例

Analysis of prognostic factors in 112 cases of ischemic stroke treated with alteplase intravenous thrombolysis

Objective To investigate the factors related to the poor prognosis of patients with acute ischemic stroke 90 days after in travenous thrombolysis with alteplase.Methods Patients with acute ischemic stroke treated with recombinant tissue plasminogen acti vator in the Department of Neurology, Jinshan Branch, Shanghai Sixth People''s Hospital from January 2016 to January 2019 were en rolled. Baseline data of the patients was collected, the modified Rankin Scale (mRS) score of patients 90 days after thrombolysis wasmeasured, and the patients were assigned into a good prognosis group (0-2 points) and a poor prognosis group (3-6 points). Binary logis tic regression was used to analyze the factors affecting the poor prognosis.Results A total of 112 patients were enrolled. Among them, 66 were males (58.93%) and 46 were females (41.07%). The 90-day follow-up showed that 75 cases (66.96%) had a good prognosis and37 cases (33.04%) had a poor prognosis. Univariate analysis showed that the patient''s age, gender, history of diabetes, history of coro nary heart disease, history of atrial fibrillation, post-stroke pneumonia, intracranial hemorrhage, DNT, and NIHSS score before throm bolysis were related to poor prognosis (P<0.1). Among them, patients with intracranial hemorrhage accounted for 27% (10/37) in thepoor prognosis group, which was much higher than 1.3% (1/75) in the good prognosis group; the NIHSS score of the patients in the poorprognosis group before thrombolysis was 18 (14, 22.5), significantly higher than 7 (5, 13) in the good prognosis group. Binary Logisticregression analysis showed that intracranial hemorrhage transformation and higher NIHSS score before thrombolysis were independentrisk factors for poor prognosis after thrombolysis (P<0.05).Conclusion The transformation of intracranial hemorrhage and the higherNIHSS score before thrombolysis are closely related to the poor prognosis 90 days after intravenous thrombolysis for acute ischemicstroke. Close monitoring and evaluation of hemorrhage transformation and accurate recording of NIHSS score before thrombolysis canprovide clinical decision-making And guiding the prognosis is of great significance.