静脉溶栓后早期神经功能改善的急性脑梗死患者预后良好

摘要

目的:评价早期神经功能改善与急性缺血性卒中患者发病90 d后预后的关系.方法:回顾性分析急性缺血性脑卒中并接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗患者的临床资料.所有患者溶栓前和溶栓后lh采用美国国立卫生研究院卒中量表(NIHSS)进行评分.将早期神经功能改善定义为溶栓后1h NIHSS评分减少≥5分或NIHSS评分=0分,用改良Rankin量表(mRS)评分来评估90 d预后,运用Logistic回归模型来分析患者早期神经功能改善和90 d预后的相关性.结果:纳入94例患者,在溶栓后lh,早期神经功能改善27例(28.72％).多因素Logistic回归分析提示,早期神经功能改善是90 d良好预后的独立预测因子(OR 6.79;95％ CI 1.73～26.61,P＜0.01).结论:急性缺血性卒中患者接受rt-PA静脉溶栓后,早期神经功能改善则90 d后具有良好预后.%Objective:To evaluate the relationship between the improvement of early neurological function and the prognosis of patients with acute ischemic stroke after onset of 90 d.Methods:All patients underwent thrombolysis prior to thrombolysis with a National Institutes of Health Stroke Scale (NIHSS) score,retrospectively analyzed for acute ischemic stroke and received intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA),1 h after thrombolysis NIHSS score.The improvement of early neurological function was defined as 1 h after thrombolysis NIHSS score reduction ≥ 5 points or NIHSS score =0,with modified Rankin scale (mRS) score to evaluate the 90 d prognosis.The use of Logistics regression model to analyze the correlation between early neurological improvement and prognosis at 90 days in patients.Results:Ninety-four patients were enrolled in this study.In the first hour after thrombolysis,there were 27 cases (28.72％) of early neurological improvement.Multivariate Logistic regression analysis showed that early neurological improvement was an independent predictor of 90-day good prognosis (OR 6.79;95％ CI 1.73～26.61,P＜0.01).Conclusion:After rt-PA intravenous thrombolysis,acute ischemic stroke patients with early neurological improvement after 90 d had a good prognosis.