国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2015年
1期
6-10
,共5页
黄志超%张霞%尤寿江%曹勇军
黃誌超%張霞%尤壽江%曹勇軍
황지초%장하%우수강%조용군
卒中%脑缺血%胱抑素C%脑出血%血栓溶解疗法%危险因素%治疗结果
卒中%腦缺血%胱抑素C%腦齣血%血栓溶解療法%危險因素%治療結果
졸중%뇌결혈%광억소C%뇌출혈%혈전용해요법%위험인소%치료결과
Stroke%Brain Ischemia%Cystatin C%Cerebral Hemorrhage%Thrombolytic Therapy%Risk Factors%Treatment Outcome
目的 探讨血浆胱抑素C(cystatin C,CysC)浓度对急性缺血性卒中患者静脉溶栓治疗转归的影响.方法 回顾性纳入连续的急性缺血性卒中静脉溶栓患者,根据改良Rankin量表评分分为转归良好组(mRS评分≤2分)和转归不良组(mRS评分＞2分),根据是否存在出血性转化(hemorrhagic transformation,HT)分为HT组和非HT组,对人口统计学和临床资料进行比较.结果 共纳入接受静脉溶栓治疗的急性缺血性卒中患者103例,转归良好组44例,转归不良组59例;TH组23例,非HT组80例.转归良好组年龄[(62.34± 13.41)岁对(68.09±9.74)岁;t=2.521,p=0.013]、基线CysC浓度[(1.008±0.28) mg/L对(1.27±0.86) mg/L;t =2.237,P=0.027]、HT发生率(14％对34.9％;x2=6.016,P=0.014)以及美国国立卫生研究院卒中量表(National Institutes ofHealth Stroke Scale,NIHSS)评分[(10.39±3.11)分对(18±2.65)分;t=13.35,P＜0.001]显著低于转归不良组.多变量logistic回归分析显示,CysC与转归之间无显著独立相关性(优势比1.783,95％可信区间0.443 ～7.185; P=0.416).非HT组基线CysC浓度[(1.41±0.54)mg/L对(0.96±0.18)mg/L;t =3.941,P=0.001]和NIHSS评分[(15.96±3.7)分对(13.05 ±4.87)分;t=3.017,P=0.004]显著低于HT组.多变量logistic回归分析显示,血浆CysC浓度＞1.03 mg/L(优势比9.050,95％可信区间2.384 ～34.359;P=0.001)是HT的独立危险因素.结论 基线血浆CysC浓度增高与急性缺血性卒中患者静脉溶栓治疗后发生HT有关,但与转归无关.
目的 探討血漿胱抑素C(cystatin C,CysC)濃度對急性缺血性卒中患者靜脈溶栓治療轉歸的影響.方法 迴顧性納入連續的急性缺血性卒中靜脈溶栓患者,根據改良Rankin量錶評分分為轉歸良好組(mRS評分≤2分)和轉歸不良組(mRS評分＞2分),根據是否存在齣血性轉化(hemorrhagic transformation,HT)分為HT組和非HT組,對人口統計學和臨床資料進行比較.結果 共納入接受靜脈溶栓治療的急性缺血性卒中患者103例,轉歸良好組44例,轉歸不良組59例;TH組23例,非HT組80例.轉歸良好組年齡[(62.34± 13.41)歲對(68.09±9.74)歲;t=2.521,p=0.013]、基線CysC濃度[(1.008±0.28) mg/L對(1.27±0.86) mg/L;t =2.237,P=0.027]、HT髮生率(14％對34.9％;x2=6.016,P=0.014)以及美國國立衛生研究院卒中量錶(National Institutes ofHealth Stroke Scale,NIHSS)評分[(10.39±3.11)分對(18±2.65)分;t=13.35,P＜0.001]顯著低于轉歸不良組.多變量logistic迴歸分析顯示,CysC與轉歸之間無顯著獨立相關性(優勢比1.783,95％可信區間0.443 ～7.185; P=0.416).非HT組基線CysC濃度[(1.41±0.54)mg/L對(0.96±0.18)mg/L;t =3.941,P=0.001]和NIHSS評分[(15.96±3.7)分對(13.05 ±4.87)分;t=3.017,P=0.004]顯著低于HT組.多變量logistic迴歸分析顯示,血漿CysC濃度＞1.03 mg/L(優勢比9.050,95％可信區間2.384 ～34.359;P=0.001)是HT的獨立危險因素.結論 基線血漿CysC濃度增高與急性缺血性卒中患者靜脈溶栓治療後髮生HT有關,但與轉歸無關.
목적 탐토혈장광억소C(cystatin C,CysC)농도대급성결혈성졸중환자정맥용전치료전귀적영향.방법 회고성납입련속적급성결혈성졸중정맥용전환자,근거개량Rankin량표평분분위전귀량호조(mRS평분≤2분)화전귀불량조(mRS평분＞2분),근거시부존재출혈성전화(hemorrhagic transformation,HT)분위HT조화비HT조,대인구통계학화림상자료진행비교.결과 공납입접수정맥용전치료적급성결혈성졸중환자103례,전귀량호조44례,전귀불량조59례;TH조23례,비HT조80례.전귀량호조년령[(62.34± 13.41)세대(68.09±9.74)세;t=2.521,p=0.013]、기선CysC농도[(1.008±0.28) mg/L대(1.27±0.86) mg/L;t =2.237,P=0.027]、HT발생솔(14％대34.9％;x2=6.016,P=0.014)이급미국국립위생연구원졸중량표(National Institutes ofHealth Stroke Scale,NIHSS)평분[(10.39±3.11)분대(18±2.65)분;t=13.35,P＜0.001]현저저우전귀불량조.다변량logistic회귀분석현시,CysC여전귀지간무현저독립상관성(우세비1.783,95％가신구간0.443 ～7.185; P=0.416).비HT조기선CysC농도[(1.41±0.54)mg/L대(0.96±0.18)mg/L;t =3.941,P=0.001]화NIHSS평분[(15.96±3.7)분대(13.05 ±4.87)분;t=3.017,P=0.004]현저저우HT조.다변량logistic회귀분석현시,혈장CysC농도＞1.03 mg/L(우세비9.050,95％가신구간2.384 ～34.359;P=0.001)시HT적독립위험인소.결론 기선혈장CysC농도증고여급성결혈성졸중환자정맥용전치료후발생HT유관,단여전귀무관.
Objective To investigate the effect of cystatin C (CysC) concentration on outcome of intravenous thrombolysis in patients with acute ischemic stroke.Methods The consecutive patients with acute ischemic stroke who underwent intravenous thrombolysis were enrolled retrospectively.They were divided into a good outcome group (≤2) and a poor outcome group (＞2) according to the Rankin scale.They were also divided into a hemorrhagic transformation (HT) group and a non-HT group according to whether they had HT or not.Their demographic data and clinical data were compared.Results A total of 103 patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled,44 in the good outcome group,59 in the poor outcome group; 23 in the TH group,and 80 in the non-HT group.The age (62.34 ± 13.41 years vs.68.09 ± 9.74 years; t-2.521,P =0.013),baseline CysC concentration (1.008±0.28 mg/L vs.1.27±0.86 mg/L; t=2.237,P=0.027),incidence of HT (14％ vs.34.9％; x2 =6.016,P =0.014) and National Institutes of Health Stroke Scale (NIHSS) score (10.39 ± 3.11 vs.18 ±2.65; t =13.35,P ＜0.001) in the good outcome group were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that there was no significant independent correlation between CysC and clinical outcome (odds ratio 1.783,95％ confidence interval 0.443-7.185 ; P =0.416).The baseline CysC concentration (1.41 ± 0.54 mg/L vs.0.96± 0.18 mg/L; t =3.941,P=0.001) and the NIHSS score (15.96 ± 3.7 vs.13.05 ±4.87; t =3.017,P =0.004) in the non-HT group were significantly lower than those in the HT group.Multivariate logistic regression analysis showed that the plasma CysC concentration ＞ 1.03 mg/L (odds ratio 9.050,95％ confidence interval 2.384-34.359; P =0.001) was an independent risk factor for HT.Conclusions The increased baseline plasma CysC concentration was associated with the occurrence of HT in patients with acute ischemic stroke after intravenous thrombolysis therapy,but it was not associated with the outcomes.
