Dragon 评分对急性缺血性卒中静脉溶栓近期疗效的预测价值

摘要

目的：探究急性缺血性卒中患者静脉溶栓前基于Dragon评分对患者14 d结局的预测作用。方法回顾性分析60例接受静脉溶栓[阿替普酶（ r-tPA）]的急性脑梗死患者，依据溶栓前的Dragon评分将患者分为3组：A组（评分小于等于3分）、B组（评分等于4分）和C组（评分大于等于5分），比较3组患者的近期（14 d）预后。依据14 d的临床疗效分为优效组和非优效组，采用Logistic回归模型分析Dragon评分对患者14 d结局的预测作用。结果 A组优效率为65．2％、B组为优效率66．7％、C组优效率27．3％，经χ2检验，A、B之间差异无统计学意义（P＞0．05），A、C组和B、C组之间差异有统计学意义（P＜0．05），且C组的治愈和显效病例评分为5分、6分和7分的例均无好的结局。溶栓后14 d 3组颅内出血转化之间差异无统计学意义（P＝1．000）。二元Logistic回归分析显示Dragon评分与缺血性卒中溶栓患者的优效率有相关性（OR＝0．566，95％Cl 0．356～0．900，P＝0．016）。结论溶栓前Dragon评分小于5分的急性缺血性卒中患者，具有更加良好的近期（14 d）预后。%Objective To evaluate the Dragon score in predicting the prognosis of acute ischemic stroke ( AIS) pa-tients with intravenous (IV) recombinant tissue plasminogen activator (rt-PA) at 14 days.Methods The data of all 60 patients who had received intravenous thrombolytic therapy were retrospectively analyzed .Patients were classified into 3 groups based on the Dragon score:group A (score≤3),group B(score=4)and group C(score≥5).Short-term prognosis of thrombolysis were compared among 3 groups.Patients were classified into 2 groups based on the excellent efficiency or non-excellent efficiency at day 14 after thrombolysis .The correlation between Dragon score and Short-term prognosis of thrombolysis was analyzed by logistic regression analysis .Results Excellent efficiency of A group was 65.2%,B group was 66.7%,C group was 27.3%.No difference was found between A and B groups (P>0.05).But the excellent efficiency of group A was significantly higher than that of group C , and group B was significantly higher than that of group C ( P<0.05).In addition,Patients in less than 5 points of Dragon scores were significantly higher than that of 6 points and 7 points,in group C.14 days after thrombolysis therapy .The intracranial hemorrhage rate of 3 groups were no statistically sig-nificant differences (P=1.000).Logistic regression analysis revealed that Dragon score was significantly associated with fa -vorable prognosis at day 14 after thrombolysis (OR=0.566,95%Cl 0.356 ~0.900,P=0.016).Conclusion Before thrombolysis therapy ,patients in less than 5 points of Dragon scores have a favorable prognosis at day 14 .