中国卒中杂志2016，Vol.11Issue(4)：277-282,6.DOI:10.3969/j.issn.1673-5765.2016.04.007
早期神经功能改善对缺血性卒中患者静脉溶栓预后的预测作用
Role of Early Neurologic Improvement in Predicting Outcome after Intravenous Recombinant Tissue Plasminogen Activator Therapy
摘要
Abstract
Objective To evaluate the role of early neurologic improvement (ENI) in predicting the outcome of acute ischemic stroke (AIS) patients with intravenous (IV) recombinant tissue plasminogen activator (rt-PA) at 90 days, by using the National Institutes of Health Stroke Scale (NIHSS) score. <br> Methods Data were collected from the Thrombolysis Implementation and Monitoring of Acute Ischemic Stroke in China (TIMS-China) registry study. NIHSS scores were recorded before IV rt-PA, at 2 and 24 hours after IV rt-PA. ENI at 2 hours was deifned as a reduction in NIHSS score by 5 or more points from baseline or a total NIHSS score of 0 at 2 hours. ENI at 24 hours was deifned as a reduction in NIHSS score by 8 or more points from baseline or a total NIHSS score of 0 at 24 hours. The outcome indexes included symptomatic intracranial hemorrhage (SICH), mortality, and 90-day functional outcomes. Logistic regression analysis was used to evaluate the role of ENI in predicting the 3-month outcome of patients. <br> Results A total of 1100 patients were included. Among which, 310 (28.18%) had ENI at 2 hours and 272 (24.73%) had ENI at 24 hours after intravenous thrombolysis. In the multivariable Logistic regression model, after adjusted for potential confounding factors including age, history of atrial ifbrillation, baseline level of blood glucose, baseline NIHSS score level and other correlated variates, no matter 2 hours or 24 hours after intravenous thrombolysis, patients in ENI group had a signiifcant improvement of favorable outcome (2 h:OR 3.772; 95%CI 2.676~5.316,P<0.001; 24 h:OR 16.392; 95%CI 10.370~25.912,P<0.001; respectively), lower mortality (2 h:OR 0.504; 95%CI 0.268~0.950, P=0.034; 24 h:OR 0.149; 95%CI 0.061~0.366,P<0.001; respectively) and the risk of SICH (2 h:OR 1.979; 95%CI 0.621~6.301,P=0.248; 24 h:OR-; 95%CI-,P=0.928; respectively) was not increased at the 3-month follow-up. <br> Conclusion IV rt-PA appears to have a favorable outcome at month 3 in ENI of patients with AIS.关键词
急性缺血性卒中/静脉溶栓/预后/早期神经功能改善Key words
Acute ischemic stroke/Thrombolysis/Outcome/Early neurologic improvement引用本文复制引用
杨寓玲,曹亦宾,廖晓凌,王春娟,赵性泉,王春雪,刘丽萍,王安心,王拥军,王伊龙..早期神经功能改善对缺血性卒中患者静脉溶栓预后的预测作用[J].中国卒中杂志,2016,11(4):277-282,6.基金项目
北京市科委2011年度科技计划重大项目--《缺血性脑卒中高危预警体系建立和规范研究》（D111107003111007）“十二五”国家科技支撑计划（2011BAI08B02）“十一五”国家科技支撑计划 （）
