CAJ | 학술논문

目的分析急性脑梗死溶栓治疗后近期(24 h)、远期(3月后)的疗效以及相关影响因素.方法对南方医科大学附属南海医院神经科自2006年1月至2011年12月收治的53例急性脑梗死患者应用尿激酶溶栓治疗,以美国国立卫生院卒中量表评分(NIHSS)及改良的Rankin量表评分(mRS)作为评价指标,评估溶栓治疗后24 h、3月后的疗效,以及对其相关影响因素进行Logistic 回归分析.结果溶栓治疗后24h病情好转者有28例(52.8％),多因素Logistic回归分析表明影响24 h疗效的因素为性别(P=0.007)、发病至溶栓治疗的间隔时间(P=0.017)及溶栓前纤维蛋白原水平(P=0.001).溶栓治疗后3月后病情好转者有40例(75.4％),多因素Logistic回归分析表明影响3月后疗效的因素为溶栓前的NIHSS评分(P=0.002)及24h的溶栓效果(P=0.002).结论影响急性脑梗死溶栓治疗远、近期疗效的因素不同,在临床工作中应分别注意对待.
목적 분석급성뇌경사용전치료후근기(24 h)、원기(3월후)적료효이급상관영향인소.방법 대남방의과대학부속남해의원신경과자2006년1월지2011년12월수치적53례급성뇌경사환자응용뇨격매용전치료,이미국국립위생원졸중량표평분(NIHSS)급개량적Rankin량표평분(mRS)작위평개지표,평고용전치료후24 h、3월후적료효,이급대기상관영향인소진행Logistic 회귀분석.결과 용전치료후24h병정호전자유28례(52.8％),다인소Logistic회귀분석표명영향24 h료효적인소위성별(P=0.007)、발병지용전치료적간격시간(P=0.017)급용전전섬유단백원수평(P=0.001).용전치료후3월후병정호전자유40례(75.4％),다인소Logistic회귀분석표명영향3월후료효적인소위용전전적NIHSS평분(P=0.002)급24h적용전효과(P=0.002).결론 영향급성뇌경사용전치료원、근기료효적인소불동,재림상공작중응분별주의대대.
[Objective]To analyze the short-term (24 h) and long-term (3 months) effects of thrombolysis in patients with acute cerebral infarction and its influencing factors.[Methods]Fifty-three patients with acute ischemic stroke,admitted to our hospital fiom January 2006 to December 201 i,were treated with urokinase (UK);the effects were observed by NIHSS and Modified Rankin Scale (mRS).Influencing factors were analyzed by Stepwise logistic regression.[Results] Twenty-eight patients had good outcome (52.8％) 24 h after thrombolytic therapy;multivariate logistic regression indicated that gender,interval between onset and receiving thrombolytic therapy,and fibrinogen level before thrombolytic therapy were the independent predictors of good outcome (P=0.007,0.017 and 0.001,respectively).Forty patients (75.4％) had good outcome 3 months after thrombolytic therapy;multivariate logistic regression indicated that the scores of NIHSS before thrombolysis and 24-h thrombolytic effect were the independent predictors of good outcome (both P=0.002).[Conclusion] Risk factors associated with short- and long-term thrombolytic effects might be different,which needs us make a difference in clinical work.