CAJ | 학술논문

目的：探讨影响重组组织型纤溶酶原激活剂（rtPA）静脉溶栓治疗急性脑梗死临床疗效的相关因素。方法26例接受rtPA静脉溶栓治疗的急性脑梗死患者，溶栓后24h复查头颅CT，观察有无颅内出血情况，并记录年龄、性别、低密度脂蛋白（LDL）水平等数据。溶栓后90d时以改良Rankin量表（mRS）评分作为评价疗效的指标，mRS评分≤2分的患者纳入预后良好组，mRS评分＞2分的纳入预后不良组，并对影响因素进行logistic回归分析。结果26例患者中3例（11.5%）示溶栓后出血转化，均为非症状性颅内出血。预后良好组患者11例（42.3%），预后不良组15例（57.7%），经logistic回归分析显示，LDL水平为预后不良的独立危险因素。结论 LDL水平越高的急性脑梗死患者rtPA静脉溶栓的效果越差。
목적：탐토영향중조조직형섬용매원격활제（rtPA）정맥용전치료급성뇌경사림상료효적상관인소。방법26례접수rtPA정맥용전치료적급성뇌경사환자，용전후24h복사두로CT，관찰유무로내출혈정황，병기록년령、성별、저밀도지단백（LDL）수평등수거。용전후90d시이개량Rankin량표（mRS）평분작위평개료효적지표，mRS평분≤2분적환자납입예후량호조，mRS평분＞2분적납입예후불량조，병대영향인소진행logistic회귀분석。결과26례환자중3례（11.5%）시용전후출혈전화，균위비증상성로내출혈。예후량호조환자11례（42.3%），예후불량조15례（57.7%），경logistic회귀분석현시，LDL수평위예후불량적독립위험인소。결론 LDL수평월고적급성뇌경사환자rtPA정맥용전적효과월차。
Objective To investigate the factors influencing the efficiency of intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) in acute cerebral infract. Methods Twenty six patients with acute cerebral infract were treat-ed by intravenous thrombolysis with rtPA, the intracranial hemorrhage was observed by brain CT 24 h after thrombolysis therapy. Clinical data including age, gender, and the level of low density lipoprotein (LDL) was recorded. The modified Rankin scale (mRS) score at d 90 was used to measure the outcome:patients with mRS score 0~2 were classified as favorable outcome, those with mRS score>2 as adverse outcome. The influencing factors related to outcome were assessed by logistic regression analysis. Results Intracranial hemorrhage occurred in 3 cases (11.5%), all of which were not symptomatic. Eleven patients (42.3%) had fa-vorable outcome, while other 15(57.7%) had adverse outcome. The results of logistic regression analysis showed that high level of LDL was an independent predictor of adverse outcome. Conclusion The acute cerebral infract patients with high level of LDL are more likely to have adverse outcome after intravenous thrombolysis with rtPA.