南京医科大学学报（自然科学版）2025，Vol.45Issue(3)：353-359,7.DOI:10.7655/NYDXBNSN241165
穿支动脉粥样硬化病高龄患者溶栓疗效及安全性分析
Therapeutic effect of intravenous thrombolysis in elderly patients with branch atheromatous disease
摘要
Abstract
Objective:To investigate the efficacy and safety of intravenous thrombolysis in elderly patients(≥80 years)with branch atheromatous disease(BAD).Methods:Old patients with BAD admitted to the Nanjing Brain Hospital Affiliated to Nanjing Medical University from January 2021 to June 2024 were retrospectively collected and divided into 60-79 years old group and≥80 years old group according to age.Clinical data,early neurological impairment,and 90 d outcomes(including efficacy and safety)were compared between the two groups.Results:A total of 156 patients were included in this study,divided into 60-79 years old group(n=114)and≥80 years old group(n=42).The≥80 years old group had higher baseline brain natriuretic peptide(BNP),prothrombin time(PT)and D-dimer levels than those of the 60-79 years old group(all P<0.05).In the effectiveness analysis,compared with the 60-79 years old group,NIHSS scores at 24 h and 7 d after intravenous thrombolysis in≥80 years old group were higher.There were significant differences between the two groups(all P<0.05).Meanwhile,≥80 years old group was more likely to experience early neurological deterioration(END)(38.1%vs.12.3%,P=0.025).There were no significant differences in 90 d mRs scores,90 d NIHSS scores,and the proportion of mRs≤2 and mRs≥4 between the two groups(all P>0.05).In addition,in the safety analysis,there was no statistical significance in the parenchymal hemorrhagic transformation and gastrointestinal bleeding between the two groups(all P>0.05),while the proportion of mucosal hemorrhage and stroke-related pneumonia(SAP)in≥80 years old group was higher than that in 60-79 years old group,with statistically significant differences(all P<0.05).Conclusion:Patients≥80 years with BAD can still benefit from intravenous thrombolysis,but END and complications need to be concerned.关键词
穿支动脉粥样硬化病/静脉溶栓/高龄/早期神经功能恶化Key words
cbranch atheromatous disease/intravenous thrombolysis/elderly patients/early neurological deterioration分类
临床医学引用本文复制引用
高甜文,马志,曹辉,邱峰..穿支动脉粥样硬化病高龄患者溶栓疗效及安全性分析[J].南京医科大学学报（自然科学版）,2025,45(3):353-359,7.基金项目
国家自然科学基金(82101497) （82101497）
江苏省自然科学基金(BK20210967) （BK20210967）
南京市医学科技发展专项资金重点项目(ZKX23039) （ZKX23039）
