CAJ | 학술논문

【目的】探讨重组组织型纤溶酶原激活剂（rt‐PA ）溶栓治疗急性脑梗死的近期疗效及影响因素。【方法】回顾性分析中国医科大学附属第四医院神经内科自2012年9月至2014年9月收治的81例急性脑梗死应用rt‐PA溶栓治疗的患者，入院及发病24 h进行美国国立卫生研究院卒中量表（NIHSS ）评分，将评分的差值作为患者结局变量，分为预后良好组（NIHSS差值≥4分或≥50％）及预后不良组（NIHSS差值＜4分或＜50％）。选取溶栓前临床及实验室资料，筛选与不良预后相关的可能因素，进行单因素及多因素分析。【结果】溶栓治疗后预后良好组42例（51．9％），预后不良组39例（48．1％），统计学分析结果显示影响溶栓疗效的因素为溶栓时间窗、血糖、NIHSS评分。【结论】静脉溶栓的近期疗效有明确的时间依赖性。血糖、NIH‐SS评分为早期预后的影响因素。
【목적】탐토중조조직형섬용매원격활제（rt‐PA ）용전치료급성뇌경사적근기료효급영향인소。【방법】회고성분석중국의과대학부속제사의원신경내과자2012년9월지2014년9월수치적81례급성뇌경사응용rt‐PA용전치료적환자，입원급발병24 h진행미국국립위생연구원졸중량표（NIHSS ）평분，장평분적차치작위환자결국변량，분위예후량호조（NIHSS차치≥4분혹≥50％）급예후불량조（NIHSS차치＜4분혹＜50％）。선취용전전림상급실험실자료，사선여불량예후상관적가능인소，진행단인소급다인소분석。【결과】용전치료후예후량호조42례（51．9％），예후불량조39례（48．1％），통계학분석결과현시영향용전료효적인소위용전시간창、혈당、NIHSS평분。【결론】정맥용전적근기료효유명학적시간의뢰성。혈당、NIH‐SS평분위조기예후적영향인소。
[Objective] To explore the short‐term efficacies and influencing factors of recombinant tissue plasminogen activator (rt‐PA) for acute cerebral infarction .[Methods] The clinical data were analyzed retro‐spectively for 81 patients with acute cerebral infarction on rt‐PA thrombolytic therapy from September 2012 to September 2014 at our department .The NIH stroke scale (NIHSS) scores were assessed at admission and 24 hours after thrombolysis .Then with score difference as outcome variables ,they were divided into good (NIH‐SS difference ≥4 points or ≥50% ) and poor (NIHSS difference <4 <50% ) prognosis groups .By selecting the pre‐thrombolysis clinical and laboratory data ,the possible factors associated with a poor prognosis were screened .And univariate and multivariate analyses were performed .[Results] Among them ,42 patients (51 .9% ) had a good prognosis and 39 (48 .1% ) a poor prognosis after thrombolysis .The results of statistical analysis showed that the influencing factors of thrombolytic efficacy included thrombolytic time window ,blood sugar and NIHSS score .[Conclusion] The short‐term efficacy of intravenous thrombolysis have a distinct time dependence .Blood glucose and NIHSS score are the influencing factors of early prognosis .