急性脑梗死动脉溶栓治疗次日病情加重的影响因素分析

目的 探讨影响急性脑梗死动脉溶栓治疗次日病情加重的影响因素。方法 118例急性脑梗死患者接受尿激酶动脉溶栓治疗。以术后次日的神经功能缺损评分作为疗效指标，分为两组：加重组和未加重组，并对性别、年龄、发病至溶栓的间隔时间、房颤、高血压、糖尿病、溶前血糖、溶前体温、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、甘油三酯（TG）、总胆固醇（TC）、颈内或大脑中动脉闭塞、溶栓24h内阿司匹林服用史、尿激酶用量（UK）、溶前白细胞计数、溶前中性粒细胞（％）、溶前血红蛋白计数、纤维蛋白原、CT早期缺血改变20个可能影响因素进行检测，并对可能影响疗效的因素进行多元Logistic回归分析。结果 未加重组66例（55．93％），加重组52例（44．07％）。单因素分析显示发病至溶栓的间隔时间、溶前血糖、溶前体温、LDL、HDL、TG、TC、颈内或大脑中动脉闭塞、溶栓24h内阿司匹林服用史、尿激酶用量为影响患者预后的危险因素；多因素Logistic回归分析结果表明仅发病至溶栓的间隔时间、溶前血糖、溶前体温、颈内或大脑中动脉闭塞、溶栓24h内阿司匹林服用史为影响急性脑梗死患者溶栓治疗次日病情加重的影响因素。结论 发病至溶栓的间隔时间、溶前血糖、溶前体温、颈内或大脑中动脉闭塞、溶栓24h内阿司匹林服用史为影响急性脑梗死患者溶栓治疗次日病情加重的影响因素。

Analysis of influencing factors for intra-arterial thrombolysis of acute cerebral infarction on following day

Objective To investigate the influencing factors which aggravate the condition of thrombolysis treated with intra-arterial thrombolysis within the next day. Methods Totals of 118 patients with acute cerebral infarction and intra--arterial urokinase were selected. All were divided into two groups according to the next day of postoperative neural functional defect： the aggravated group and no aggravated group,20 risk factors such as gender, age, time interval between onset to thrombolysis, atrial fibrillation, hypertension, diabetes mellitus, blood glucose and body temperature before thrombolysis, low density lipoprotein （LDL）, high density lipoprotein （ HDL）, triglyceride （TG）, total cholesterol （TC）, the occlusion of internal carotid or middle cerebral artery, the aspirin use history within 24 h after thrombolysis, the dosage of urokinase （UK）, the leukocyte count before thrombolysis, the neutrophil, the haemoglobin count before thrombolysis, fibrinogen and CT early ischemic change of were detected. Last, analyzed the influential factors by multivariate logistic regression analysis. Results There were 66 cases belonged to the aggravated group （accounting for 55.93%）, and 52 cases belonged to no aggravated group （accounting for 44.07%）. Univariate analysis showed that the time interval between onset to thrombolysis, blood glucose and body temperature before thromoplysis, LDL, HDL, TG, TC, the occlusion of internal carotid or middle cerebral artery, the aspirin use history within 24 h after thrombolysis and the dosage of UK were the risk factors to influence prognosis, multivariate Logistic regression showed that the time interval between onset to thrombolysis, blood glucose and body temperature before thrombolysis, the occlusion of internal carotid or middle cerebral artery and the aspirin use history within 24 h after thrombolysis were independent predictors to aggravate the condition of patients with the next day of thrombolysis. Conclusions The time interval between onset to thromb