房颤、血清CysC、Hcy水平对rt-PA静脉溶栓治疗急性脑梗死患者预后结局的影响

目的 探讨房颤、血清胱抑素C(CysC)、同型半胱氨酸(Hcy)水平对阿替普酶(rt-PA)静脉溶栓治疗急性脑梗死(ACI)患者预后结局的影响.方法 回顾性分析我院2017年5月至2020年2月收治的100例采用rt-PA静脉溶栓治疗的ACI患者的临床资料,根据治疗后90 d的预后情况将患者分为预后良好组(67例)和预...

Effects of atrial fibrillation,serum CysC and Hcy levels on the prognosis of patients with acute cerebral infarction treated with rt-PA intravenous thrombolysis

Objective To investigate the effects of atrial fibrillation, serum cystatin C(CysC) and homocysteine(Hcy)levels on the prognosis of patients with acute cerebral infarction(ACI) treated with alteplase(rt-PA) intravenous thrombolysis. Methods The clinical data of 100 patients with ACI treated with rt-PA intravenous thrombolysis admitted in our hospital from May 2017 to February 2020 were analyzed retrospectively, and the patients were divided into good prognosis group(67 cases) and poor prognosis group(33 cases) according to the prognosis at 90 d after treatment. The general data and laboratory indexes of the two groups were compared. The risk factors affecting the prognosis of rt-PA intravenous thrombolysis therapy in patients with ACI were analyzed. Results The combined coronary heart disease rate atrial fibrillation rate, and the national institutes of health neurological impairment scale(NIHSS) score in the poor prognosis group were higher than those in the good prognosis group, and the Glasgow coma scale(GCS) score was lower than that in the good prognosis group, and the differences were statistically significant(P<0.05). There were no significant differences in the white blood cell count(WBC), neutrophil count, platelet count(PLT) and serum creatinine(Scr), urea nitrogen(BUN), fibrinogen(Fib) and blood glucose(GLU) levels between the two groups(P >0.05);the levels of CysC,Hcy, D-dimer(D-D) and glycosylated hemoglobin(HbA1 c) in the poor prognosis group were higher than those in the good prognosis group, and the differences were statistically significant(P<0.05). Logistic regression analysis result showed that atrial fibrillation, NIHSS and GCS scores, CysC and Hcy levels were independent risk factors for poor prognosis of ACI patients treated with rt-PA intravenous thrombolysis(P <0.05). Conclusion Accompanied by atrial fibrillation,increased CysC and Hcy levels are independent risk factors for poor prognosis of ACI patients treated with rt-PA intravenous thrombolysis. The above indexes should be monitored during clinical treatment and the treatment plan should be adjusted in time to improve the prognosis effect of patients.