中国实用神经疾病杂志2025，Vol.28Issue(7)：844-849,6.DOI:10.12083/SYSJ.240807
溶栓治疗后梗死病灶内组织损伤程度在急性缺血性脑卒中患者预后评估中的价值
Value of intra-infarct tissue damage after thrombolytic therapy in prognosis assessment of patients with acute ischemic stroke
摘要
Abstract
Objective To investigate the value of intra-infarct tissue damage after thrombolytic therapy in prognosis assessment of patients with acute ischemic stroke.Methods A total of 202 patients with acute ischemic stroke treated by thrombolysis in Jiamusi Central Hospital from January 2021 to January 2023 were selected as the study objects.After treatment,the prognosis was evaluated using the modified Rankin scale(mRS)score and the patients were divided into the good prognosis group(mRS≤2 points)and the poor prognosis group(mRS≥3 points).Ktrans value was used to evaluate the degree of tissue damage in infarct lesions after thrombolytic therapy.Multivariate Logistic regression model was used to analyze the influencing factors of prognosis.ROC curve was used to evaluate the predictive value of tissue damage in infarct lesions for prognosis.Results After 3 months of follow-up,3 patients were lost to follow-up,and 199 patients were finally included,of which 59 patients with mRS score≥3 were classified as the poor prognosis group,and the remaining 140 patients with mRS score≤2 were classified as the good prognosis group.Atrial fibrillation was less in the good prognosis group than that in the poor prognosis group,and the infarct volume and baseline NIHSS score were lower than those in the poor prognosis group(P<0.05).Multivariate Logistic analysis showed that atrial fibrillation(OR=3.535,95%CI:1.125-11.106),NIHSS score(OR=1.352,95%CI:1.177-1.552),infarct volume after thrombolytic therapy(OR=1.443,95%CI:1.044-1.9959),Ktrans after thrombolytic therapy(OR=5.183,95%CI:2.923-9.189)were risk factors for poor prognosis in patients treated by thrombolytic therapy(P<0.05).ROC curve analysis showed that Ktrans had the highest prognostic AUC of 0.831(95%CI:0.772-0.880)after thrombolysis.The specificity was 62.41%and the sensitivity was 89.93%.Conclusion After thrombolytic therapy for acute ischemic stroke,the degree of tissue damage in infarction lesions is related to the prognosis.Besides minimizing the infarct volume,reducing the degree of tissue damage in infarction lesions may be the mechanism of improving the prognosis of patients treated by thrombolytic therapy.关键词
急性缺血性脑卒中/溶栓/梗死病灶/梗死体积/预后/Ktrans值Key words
Acute ischemic stroke/Thrombolysis/Infarct focus/Infarct tissue/Prognosis/Ktrans value分类
医药卫生引用本文复制引用
闫博阳,许丽华,朱剑芒,姜国清,钱文军..溶栓治疗后梗死病灶内组织损伤程度在急性缺血性脑卒中患者预后评估中的价值[J].中国实用神经疾病杂志,2025,28(7):844-849,6.基金项目
黑龙江省卫生健康委科技计划项目(编号:20220303071156) （编号:20220303071156）
