蔡智立;何奕涛;周致帆;陈思言;王倩;张慧;黄莹;杨苗娟;郭毅;

• 1:深圳市人民医院(暨南大学第二临床医学院南方科技大学附属第一医院)

摘要(Abstract)：

目的通过回顾性调查研究探讨脑梗死患者的基线情况与其静脉溶栓早期疗效的关系,并提出相关的建议,为静脉溶栓治疗提供参考和依据。方法以深圳市人民医院收治的249例急性脑梗死静脉溶栓治疗的患者为研究对象,收集患者基线资料,以NIHSS评分的差值作为结局变量将患者分为有效组和无效组,分析阿替普酶静脉溶栓早期的疗效及其影响因素。结果溶栓后1h有效62例(24.90%),溶栓后24h有效118例(47.39%),溶栓后第7天有效165例(66.27%)。溶栓1h有效组房颤史比例、溶栓前NIHSS评分明显均低于无效组(P<0.05)。经Logistic回归分析发现,既往房颤史、溶栓前NIHSS评分是静脉溶栓1h后影响神经功能恢复的独立因素。溶栓24h后有效组发病至溶栓的时间(onset to treatment,OTT)、房颤史比例、溶栓前NIHSS评分、溶栓前血糖水平均低于无效组(P<0.05),经Logistic回归分析,OTT、房颤史、溶栓前血糖水平、溶栓前NIHSS评分是静脉溶栓24h后影响神经功能恢复的独立因素。溶栓7d后有效组OTT、溶栓前NIHSS评分均低于无效组(P<0.05),经Logistic回归分析,OTT、溶栓前NIHSS评分是静脉溶栓7d后影响神经功能恢复的独立因素。结论阿替普酶静脉溶栓有效率随时间的推移逐渐升高。房颤史、溶栓前血糖水平、溶栓前NIHSS评分、OTT是阿替普酶静脉溶栓后早期神经功能改善的独立影响因素。

关键词(KeyWords)： 脑梗死;静脉溶栓;阿替普酶;神经功能;血糖;发病至溶栓的时间;NIHSS评分

Abstract:

Keywords:

基金项目(Foundation): 广东省医学科研基金面上项目(编号：A2019442)

作者(Authors): 蔡智立;何奕涛;周致帆;陈思言;王倩;张慧;黄莹;杨苗娟;郭毅;

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