97例急性脑梗死患者阿替普酶静脉溶栓疗效及出血性转化影响因素分析.docVIP

97例急性脑梗死患者阿替普酶静脉溶栓疗效及出血性转化影响因素分析 　　摘 要 目的：分析阿替普酶静脉溶栓治疗急性脑梗死患者的临床疗效和溶栓后发生出血性转化的相关因素。方法：190例急性脑梗死患者根据治疗方法的不同分为静脉溶栓组（n=97）和常规治疗组（n=93），比较治疗前和治疗后24 h、7 d NIHSS评分。静脉溶栓组患者根据有无出血分为出血性转化亚组（n=33）和无出血性转化亚组（n=64），比较年龄、性别、溶栓前血压、NHISS评分、血糖、溶栓时间、合并高血压、糖尿病、既往卒中病史、房颤病史等方面的差异。结果：治疗后24 h、7 d 静脉溶栓组NHISS评分明显低于低于常规治疗组（P0.05）。多因素 logistic 回归分析结果显示，溶栓前血糖、溶栓前NHISS评分、既往房颤病史是阿替普酶静脉溶栓后发生出血性转化的独立影响因素。结论：阿替普酶?o脉溶栓治疗发病6 h内急性脑梗死疗效优于常规治疗。溶栓前血糖较高、NIHSS评分较高、既往房颤病史的急性脑梗死患者应用阿替普酶静脉溶栓治疗后出血性转化发生率较高。 　　关键词 急性脑梗死 阿替普酶 静脉溶栓 出血性转化 影响因素 　　中图分类号：R743.33； R972.9 文献标识码：A 文章编号：1006-1533（2017）23-0025-03 　　The efficacy of intravenous thrombolytic therapy in 97 patients with acute cerebral infarction and the analysis of impact factors of hemorrhagic transformation 　　LI Fan 　　（No.1 Ward， Department of Neurology， the People’s Hospital of Xixia County， Nanyang 474550， China） 　　ABSTRACT Objective： To analyze the clinical efficacy of intravenous thrombolytic therapy in the treatment of acute cerebral infarction （ACI） and the related factors of hemorrhagic transformation after thrombolysis. Methods： One hundred and ninety cases of ACI patients were selected and divided into an intravenous thrombolysis group （n=97） and a conventional treatment group （n=93） on the basis of therapy. The NIHSS score before treatment and at 24 hours and 7 days after treatment were compared between the two groups. The patients in the intravenous thrombolysis group were subdivided into a hemorrhagic transformation subgroup （n=33） and a non-hemorrhagic transformation subgroup （n=64） and the differences in age， sex， blood pressure before intravenous thrombolysis， NHISS score， blood glucose level， thrombolytic time， complicated with hypertension， diabetes， history of stroke and atrial fibrillation were compared as well. Results： The NHISS scores at 24 hours and 7 days after treatment were lower in the intravenous thrombolysis group than in the conventional treatment group （P0.05）. Multivariate logistic regression analysis suggested that bl