摘要
目的探讨急性缺血性卒中的患者应用阿替普酶溶栓后的短期预后以及TOAST、OCSP两种分型与急性缺血性脑卒中患者预后的关系。方法回顾性分析2019年1月至2020年6月中山大学孙逸仙纪念医院急诊科来诊的急性缺血性脑卒中住院患者193例[其中男性158例,女性85例,年龄(69.46±13.02)岁],其中应用阿替普酶溶栓治疗患者66例,未应用溶栓治疗患者127例,比较溶栓患者与未溶栓患者短期预后;分析TOAST分型、OCSP分型对急性缺血性卒中预后的影响。结果:溶栓组与未溶栓组的住院天数差异无统计学意义(P>0.05),而入院和出院时NIHSS评分好转率、GCS评分、mRS评分均差异有统计学意义(P<0.05)。根据TOAST分型LAA 78例(40.41%),SAO 100例(51.81%),CE9例(4.66%),SOE3例(1.55%),SUE3例(1.55);其中SAO型占得比例最高(51.81%),入院和出院时NIHSS评分好转率与LAA组比较差异有统计学意义(P<0.05),短期预后最好。OCSP分型中LACI 39例(20.21%),PACI 64例(33.16%),POCI 55例(28.50%),TACI 35例(18.13%),其中PACI组所占比例最高,而LACI组入院和出院时NIHSS评分好转率与其他组相比差异有统计学意义(P<0.05),短期预后好。结论急性缺血性卒中患者经过阿替普酶溶栓治疗后短期预后、症状改善效果明显,TOAST病因分型和OCSP临床分型对急性缺血性卒中患者的短期预后有一定的预测和临床参考作用。
Objective To investigate the short-term prognosis of patients with acute ischemic stroke after thrombolysis with alteplase and the relationship between TOAST and OCSP classification and prognosis of patients with acute ischemic stroke.Methods A retrospective analysis was conducted in 193 patients with acute ischemic stroke in the Emergency Department of our hospital from January 2019 to June 2020,including 158 males and 85 females,aged 69.46±13.02 years.Among them,66 patients were treated with alteplase thrombolysis and 127 patients were not treated with thrombolysis.The short-term prognosis of thrombolytic patients and non-thrombolytic patients were compared;the influence of TOAST classification and OCSP classification on the prognosis of acute ischemic stroke was analyzed.Results There was no signifi cant difference in the length of hospital stay between the thrombolytic group and the non-thrombolytic group(P>0.05),while the improvement rate of NIHSS score,GCS score,and mRS score were signifi cantly different at admission and discharge(P<0.05).According to TOAST classifi cation,78 cases(40.41%)were LAA,100 cases(51.81%)were SAO,9 cases(4.66%)were CE,3 cases(1.55%)were SOE,and 3 cases(1.55%)were SUE;SAO type accounted for the highest proportion(51.81%),the improvement rate of NIHSS score at admission and discharge was signifi cantly different from that of the LAA patients(P<0.05),and the short-term prognosis was the best.According to OCSP classifi cation,39 cases(20.21%)were LACI,64 cases(33.16%)were PACI,55 cases(28.50%)were POCI,35 cases(18.13%)were TACI,among which the PACI patients had the highest proportion,while the improvement rate of NIHSS score in the LACI patients was signifi cantly different at admission and discharge compared with other types of patietns(P<0.05),and the short-term prognosis was good.Conclusions The short-term prognosis and symptom improvement of patients with acute ischemic stroke after alteplase thrombolytic therapy are obvious.TOAST classifi cation and OCSP classifi cation have certain prediction effects and play clinical reference roles on the short-term prognosis of patients with acute ischemic stroke.
作者
张洁
黄云苑
杨正飞
蒋龙元
Zhang Jie;Huang Yunyuan;Yang Zhengfei;Jiang Longyuan(Department of Emergency Medicine,Sun Yat-sen Memorial Hospital,Zhongshan University,Guangzhou 510120,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2021年第2期204-207,共4页
Chinese Journal of Emergency Medicine
