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Effects of Ultra-early Alteplase Intravenous Thrombolysis in Patients with Acute Cerebral Infarction and the Influencing Factors of Deterioration after Improvement |
ZHANG Hong, WANG Yan-ping, WANG Hong-lei |
Department of Encephalopathy,Meishan Traditional Chinese Medicine Hospital, SiChuan 620010 China |
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Abstract 【Objective】To analyze the effects of ultra-early alteplase (rt-PA) intravenous thrombolysis in patients with acute cerebral infarction (ACI) and the influencing factors of deterioration after improvement. 【Methods】A total of 70 patients with ACI treated by rt-PA intravenous thrombolysis in our hospital from January 2014 to December 2016 were selected as the observation group, and 90 patients with ACI in the same period who only received conventional treatment were selected as the control group. The status of neurological impairment was evaluated with the National Institutes of Health Stroke Scale (NIHSS) and the prognosis was evaluated with the Barthel index (BI) and modified Rankin scale (mRS). The incidence of complications was statistically analyzed. Furthermore, patients in the observation group were divided into the deterioration group (n=9) and the non-deterioration group (n=71). The clinical data were collected for univariate analysis and factors with significant differences were analyzed by logistic regression analysis. 【Results】Before treatment, there were no significant differences between the two groups in NIHSS score, BI and mRS scores, while after treatment, the above-mentioned indexes were significantly improved and the improvement was more obvious in the observation group than the control group. Multivariable logistic regression analysis showed that age, previous history of atrial fibrillation, late thrombolysis, high NIHSS score before thrombolysis, low white blood cell count and total anterior circulation infarction were independent risk factors for deterioration after improvement. 【Conclusion】Ultra-early rt-PA intravenous thrombolysis can quickly correct the status of cerebral ischemia and hypoxia and save the damaged neurological function in patients with ACI. Attention should be paid to the independent risk factors for deterioration after improvement.
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Received: 30 September 2017
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[1] 金涛, 朱广军, 韩光李凤昌,等. 亚急性期脑梗死患者数字减影全脑血管造影致脑栓塞的危险因素分析[J]. 湖南师范大学学报(医学版), 2015, 20(1):98-100. [2] 唐海源, 邹永彪, 张春华,等. 阿替普酶静脉溶栓治疗心源性脑栓塞31例临床疗效[J]. 医学临床研究, 2015,32(2):320-322. [3] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010[J]. 中华神经科杂志, 2010, 43(2):16-19. [4] 中华医学会神经病学分会. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志, 2015, 48(4):246-257. [5] 黄镪, 马青峰, 冯娟,等. 急性缺血性卒中静脉溶栓决策的影响因素[J]. 中国脑血管病杂志, 2016, 13(1):13-16. [6] 李艳琴, 刘斌, 李世英,等. 急性脑梗死病因分型及进展[J]. 中国煤炭工业医学杂志, 2015,18(7):1247-1252. [7] 朱方方, 张友好, 冯敏,等. 同型半胱氨酸、超敏C反应蛋白、低密度脂蛋白、三酰甘油、总胆固醇与急性脑梗死的关系研究[J]. 蚌埠医学院学报, 2016, 41(5):623-625. [8] 刘静, 吴雅坤. 急性脑梗死rt-PA溶栓治疗进展[J]. 河北医科大学学报, 2016, 37(3):355-357. [9] 刘璇, 李秀荣, 闻红斌,等. 急性脑梗死患者静脉溶栓后出现出血转化的危险因素分析[J]. 医学综述, 2016, 22(6):1228-1230. [10] 李婷婷, 郝应禄, 李燕萍,等. 低分子肝素在阿替普酶溶栓治疗中的应用[J]. 昆明医科大学学报, 2016, 37(5):93-96. [11] 薛桦. 尿激酶与阿替普酶治疗急性脑梗死的疗效对比[J]. 药物评价研究, 2016, 39(5):828-831. [12] 鲁文先, 苏毅鹏, 陈金波,等. 急性脑梗死患者阿替普酶静脉溶栓的疗效及出血性转化影响因素分析[J]. 脑与神经疾病杂志, 2017, 25(1):29-33. [13] 钟建斌, 沈庆煜, 陈炽邦,等. 超高龄脑梗死患者超早期应用阿替普酶静脉溶栓治疗的效果及安全性[J]. 实用医学杂志, 2016, 32(7):1058-1060. [14] 崔颖, 佟旭, 王伊龙,等. 急性缺血性卒中患者阿替普酶静脉溶栓后发生早期神经功能恶化的危险因素分析[J]. 中华神经科杂志, 2016, 49(12):925-931. [15] 李克良, 耿瑞慧, 朱立勋,等. 影响阿替普酶治疗急性缺血性卒中早期疗效的临床研究[J]. 现代生物医学进展, 2017, 17(8):1464-1467. |
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