FENG Haixia 1QIU Hongyan 2REN Lijie 1et al.2
作者信息
- 1. Department of Neurology,Peking University Shenzhen Hospital,Shenzhen 518036,China
- 折叠
摘要
Abstract
Objective To explore the efficacy and safety of intravenous thrombolysis with rt-PA for mild acute ische-mic stroke,and the risk factors of poor prognosis in these patients. Methods From January 2016 to May 2018,we prospec-tively analysed analyzed 224 patients with acute ischemic stroke received intravenous thrombolysis with rt-PA in 6 stroke centers in Shenzhen,minor stroke(MS) was defined as National Institutes of Health Stroke Scale( NIHSS)≤5,including 116 patients,non-minor stroke( NMS) was defined as NIHSS>5,including 108 patients. The baseline data,the modified Rankin scale(mRS)in the 90-day,the rate of symptomatic intracerebral hemorrhage(sICH) and early neurological deterio-ration (END) during 7 days after treatment,the mortality in the 90-day between the two groups were compared. Univariate and multivariate logistic regression analysis was used to explore the risk factors of poor prognosis in MS patients treated with rt-PA. Results Compared with NMS,the proportion of cardiogenic embolism stroke in MS was significantly lower(7. 8% vs 17. 6% ,P=0. 026),while the proportion of small artery occlusive stroke was significantly higher(41. 4% vs 24. 1% ,P=0. 006). In efficacy,the proportion of the good outcome in the 90-day (mRS≤2) in MS group was obviously significantly higher than that in NMS group(87. 9% vs 63% ,OR 6. 099,95% CI 2. 650~14. 040,P<0. 001). In safety,compared with NMS,the rate of END was higher(5. 2% vs 4. 6% ),the rate of sICH was lower(4. 3% vs 6. 5% ),the mortality in the 90-day was lower(1. 7% vs 7. 4% ) in the MS group,there was no significant difference before and after correcting confounding factors. In Univariate logistic regression analysis,even received rt-PA,large artery atherosclerotic stroke,END,previous his-tory of ischemic stroke and previous antiplatelet therapy were associated with poor prognosis in MS patients,while in multi-variate logistic regression analysis,only END was associated with poor prognosis. Conclusion Compared with NMS,intra-venous thrombolysis with rt-PA for MS patients can improve the 90-day neurological function,the safety is similar as NMS. Even received rt-PA,END is still an independent risk factor for poor prognosis in MS patients.关键词
轻型卒中/静脉溶栓/疗效性/安全性Key words
Minorstroke/Intraveousthrombolysis/Efficacy/Safety分类
医药卫生
