MESSS评分与NIHSS评分对急性脑梗死患者静脉溶栓预后评估分析.docVIP

MESSS评分与NIHSS评分对急性脑梗死患者静脉溶栓预后评估分析 　　【摘要】 目的：探讨改良爱丁堡-斯堪的纳维亚评分（MESSS）及美国国立卫生研究所脑卒中评分（NIHSS）两种评分量表对急性脑梗死（ACI）患者静脉重组组织型纤溶酶原激活剂（rt-PA）溶栓的预后分析。方法：选取经确诊为ACI并行rt-PA静脉溶栓治疗的患者118例作为研究对象，发病后第90天行改良Rankin量表（mRS）进行评分，依据mRS评分结果将患者分为预后良好组（67例）和预后不良组（51例），并对两组患者的一般临床资料进行观察比较分析。结果：（1）两组患者年龄、糖尿病史、溶栓前MESSS评分及NIHSS评分、起病至治疗时间差异均有统计学意义（P0.05）；（2）多因素Logistic回归分析显示，患者溶栓治疗后出现不良预后与糖尿病史、溶栓前MESSS评分、NIHSS评分具有相关性，差异有统计学意义（P0.05）。结论：MESSS评分与NIHSS评分对ACI患者静脉rt-PA溶栓的预后具有较好的评估价值。 　　【关键词】 MESSS评分； NIHSS评分； 急性脑梗死； 静脉溶栓； 预后 　　doi：10.14033/j.cnki.cfmr.2017.8.010 文献标识码 B 文章编号 1674-6805（2017）08-0017-03 　　【Abstract】 Objective：To analyze the MESSS and NIHSS scoring systems on evaluation of prognosis of acute cerebral infarction（ACI） treated with intravenous thrombolysis.Method：118 patients with ACI treated by recombinant tissue plasminogen activator（rt-PA） were selected.The patients were evaluated at 90 d after attacked by modified Rankin Scale（mRS） score，and all cases were divided into good prognosis group（n=67） and poor prognosis group（n=51）.The clinical data of two groups were observed and compared.Result：（1）There were statistically significant differences between the two groups on age，history of diabetes mellitus，MESSS score and NIHSS score before thrombolysis，and time from attack to treatment.（2）Logistic multivariate regression analysis showed that the poor prognosis of ACI were as follow history of diabetes mellitus，MESSS score and NIHSS score before thrombolysis.Conclusion：MESSS score and NIHSS score have a good predictive value in the prognosis of ACI treated with intravenous thrombolysis by rt-PA. 　　【Key words】 MESSS score； NIHSS score； Acute cerebral infarction； Intravenous thrombolysis； Prognosis 　　First-author’s address：Hanyang Hospital Affiliated to Wuhan University of Science and Technology，Wuhan 430050，China 　　急性?X梗死（acute cerebral infarction，ACI）是指因脑血流供应不足或中断所致的脑组织不可逆性缺血缺氧性坏死[1]。目前ACI的治疗主要是超早期的血管再通，尤其对发病在时间窗内（4.5 h内）且排除溶栓禁忌可行紧急静脉溶栓治疗[2]。近年来，临床上使用的改良爱丁堡-斯堪的纳维亚评分（the modified Edinburgh-