急性脑梗死患者急诊介入溶栓治疗后早期神经功能恶化影响因素分析

doi:10.3969/j.issn.1006-6233.2024.04.016

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摘要 目的: 探讨急性脑梗死患者急诊介入溶栓治疗早期神经功能恶化(END)影响因素。方法: 选择我院于2020年3月至2023年3月行急诊介入溶栓治疗的急性脑梗死患者105例,按照溶栓内24h是否发生END,分为END组34例与非END组71例。采用单因素分析影响END的相关因素;多因素Logistic回归分析影响END独立危险因素。结果: 经单因素分析计数资料显示,END组和非END组性别、年龄、BMI、吸烟史、饮酒史、高血压史、糖尿病史、冠心病史和责任大血管分布差异无统计学意义(P>0.05);END组和非END组责任大血管狭窄程度比较差异具有统计学意义(P<0.05)。经单因素分析计量资料显示,END组与非END组入院时NIHSS评分、溶栓时间、白细胞计数、中性粒细胞计数、Lp-PLA2水平和脂蛋白a水平比较差异具有统计学意义(P<0.05);而END组与非END组发病至溶栓时间、D-二聚体和Hcy水平比较差异无统计学意义(P>0.05)。多因素Logistic回归分析的结果显示,责任大血管狭窄程度、入院时NIHSS评分、溶栓时间、白细胞计数、中性粒细胞计数、Lp-PLA2和脂蛋白a为影响END独立危险因素。结论: 急性脑梗死患者急诊介入溶栓治疗后END发生率较高,且受多因素影响,其中责任大血管狭窄程度、入院时NIHSS评分、溶栓时间、白细胞计数、中性粒细胞计数、Lp-PLA2和脂蛋白a为影响END独立危险因素。

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	张峰
	季流
	葛春阳
	李海山

关键词 ：急性脑梗死, 急诊介入溶栓治疗, 早期神经功能恶化, 影响因素

Abstract：Objective: To investigate the factors influencing early neurological deterioration (END) after emergency interventional thrombolysis in patients with acute cerebral infarction. Methods: A total of 105 patients with acute cerebral infarction who underwent emergency interventional thrombolysis in our hospital from March 2020 to March 2023 were enrolled in this study. According to whether END occurred within 24 hours after thrombolysis, the patients were divided into the END group (n=34) and the non-END group (n=71). Univariate analysis was used to analyze the factors related to END, and multivariate logistic regression analysis was used to analyze the independent risk factors for END. Results: Univariate analysis showed no significant differences between the END and non-END groups in terms of gender, age, BMI, smoking history, drinking history, hypertension history, diabetes history, coronary heart disease history, and distribution of the responsible large vessel (P>0.05). However, the degree of stenosis of the responsible large vessel was significantly different between the END and non-END groups (P<0.05). Univariate analysis of the quantitative data showed that the National Institutes of Health Stroke Scale (NIHSS) score, thrombolysis time, white blood cell count, neutrophil count, Lp-PLA2 level, and lipoprotein a level were significantly different between the END and non-END groups (P<0.05). However, there were no significant differences between the END and non-END groups in terms of time from onset to thrombolysis, D-dimer level, and Hcy level (P>0.05). Multivariate logistic regression analysis showed that the degree of stenosis of the responsible large vessel, NIHSS score on admission, thrombolysis time, white blood cell count, neutrophil count, Lp-PLA2, and lipoprotein a were independent risk factors for END. Conclusion: The incidence of END after emergency interventional thrombolysis in patients with acute cerebral infarction is high and is influenced by multiple factors. The degree of stenosis of the responsible large vessel, NIHSS score on admission, thrombolysis time, white blood cell count, neutrophil count, Lp-PLA2, and lipoprotein a are independent risk factors for END.

Key words： Acute cerebral infarction Emergency interventional thrombolysis treatment Early deterioration of neurological function Influence factor

基金资助:2020年度安徽省自然科学基金项目,(编号:2008085QH353)

通讯作者: 李海山

引用本文:

张峰, 季流, 葛春阳, 李海山. 急性脑梗死患者急诊介入溶栓治疗后早期神经功能恶化影响因素分析[J]. 河北医学, 2024, 30(4): 613-618.
ZHANG Feng, JI Liu, GE Chunyang, et al. Analysis of Factors Influencing Early Neurological Deterioration after Emergency Interventional Thrombolysis in Patients with Acute Cerebral Infarction. HeBei Med, 2024, 30(4): 613-618.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.04.016 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I4/613

[1] Masson A,Boulouis G,Janot K,et al.Acute hydrocephalus and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage[J].Acta Neurochir,2022,164(9):2401-2408.
[2] Liu F,Jin M,Zhang Z,et al.Platelet-to-neutrophil ratio is related to hemorrhagic transformation in patients with acute cerebral infarction[J].Neurologist,2022,27(5):230-234.
[3] 孙瑜,魏爱宣,王利民,等.急性脑梗死静脉溶栓后早期神经功能恶化的影像学特征分析[J].中国实验诊断学,2023,27(5):568-571.
[4] 刘雪云,方琪,吴小三,等.脑白质高信号与急性缺血性脑卒中静脉溶栓后早期神经功能恶化的相关性研究[J].中华神经医学杂志,2022,21(3):257-262.
[5] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学,2011,14(35):4013-4017.
[6] 谈颂,常思远,宋波,等.早期改良美国国立卫生研究院卒中量表评分对缺血性卒中诊治指南(2014)[J].中华神经科杂志,2015,48(4):246-257.
[7] Shao YJ,Zhang Y,Wu RR,et al.Network pharmacology approach to investigate the multitarget mechanisms of Zhishi Rhubarb Soup on acute cerebral infarction[J].Pharm Biol,2022,60(1):1394-1406.
[8] Bao H,Gao HR,Pan ML,et al.Comparative study on the efficacy and safety of alteplase and urokinase in the treatment of acute cerebral infarction[J].Technol Health Care,2021,29(1):85-90.
[9] 穆永芳,郭永力,蒋召芹,等.阿替普酶治疗急性脑梗死患者的疗效、血清ET-1、TXA2水平及不良反应影响[J].湖南师范大学学报(医学版),2022,19(2):208-211.
[10] 兰翠霞,王健,王江凤,等.血清Lp-PLA2、RDW-CV、NLR值变化与急性脑梗死患者早期神经功能恶化及预后的关系[J].中国现代医学杂志,2023,33(10):12-17.
[11] 华键,周其达.急性脑梗死早期神经功能恶化与高密度脂蛋白胆固醇及脂蛋白(a)的关系[J].中华老年心脑血管病杂志,2018,20(4):405-407.