摘要
目的:分析老年急性缺血性卒中患者采用重组组织型纤溶酶原激活剂(rt-PA)溶栓后发生早期神经功能恶化(END)的影响因素。方法:回顾性分析2021年5月至2023年1月该院收治的98例老年急性缺血性卒中患者的临床资料。统计老年急性缺血性卒中患者rt-PA溶栓后7 d内END发生情况,采用Logistic回归分析老年急性缺血性卒中患者rt-PA溶栓后发生END的影响因素。结果:98例老年急性缺血性卒中患者rt-PA溶栓后7 d内发生END 29例(设为END组),发生率为29.59%;未发生END 69例(70.41%),设为非END组;END组合并糖尿病、责任大血管闭塞、合并吞咽障碍、心源性栓塞、未进行抗血小板治疗等占比均高于非END组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,合并糖尿病、责任大血管闭塞、存在吞咽障碍、心源性栓塞、未进行抗血小板治疗等均为影响老年急性缺血性卒中患者rt-PA溶栓后发生END的危险因素(OR>1,P<0.05)。结论:合并糖尿病、责任大血管闭塞、合并吞咽障碍、心源性栓塞、未进行抗血小板治疗等均为影响老年急性缺血性卒中患者rt-PA溶栓后发生END的危险因素。
Objective:To analyze influencing factors of early neurological deterioration(END)in elderly patients with acute ischemic stroke after recombinant tissue plasminogen activator(rt-PA)thrombolysis.Methods:The clinical data of 98 elderly patients with acute ischemic stroke admitted to this hospital from May 2021 to January 2023 were retrospectively analyzed.The incidence of END within 7 days after rt-PA thrombolysis in these patients was statistically analyzed.Logistic regression was used to analyze the influencing factors of END in the elderly patients with acute ischemic stroke after rt-PA thrombolysis.Results:Among the 98 elderly patients with acute ischemic stroke,29 cases(29.59%)had END within 7 days after rt-PA thrombolysis(set as END group),and the remaining 69 cases(70.41%)without END were set as non-END group.The proportions of combined diabetes,combined responsible large vessel occlusion,combined dysphagia,combined cardiogenic embolism,and no antiplatelet therapy in the END group were higher than those in the non-END group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that combined diabetes,combined responsible large vessel occlusion,combined dysphagia,combined cardiogenic embolism,and no antiplatelet therapy were all risk factors affecting the occurrence of END in the elderly patients with acute ischemic stroke after rt PA thrombolysis(OR>1,P<0.05).Conclusions:Combined diabetes,combined responsible large vessel occlusion,combined dysphagia,combined cardiogenic embolism,and no antiplatelet therapy are the risk factors for END in the elderly patients with acute ischemic stroke after rt-PA thrombolysis.
作者
韩敬民
HAN Jingmin(Second Department of Neurology of Qingfeng First Hospital,Puyang 457300 Henan,China)
出处
《中国民康医学》
2024年第12期1-3,7,共4页
Medical Journal of Chinese People’s Health
