摘要
目的分析老年急性缺血性脑卒中患者静脉溶栓出血危险因素并构建出血预警模型。方法选取2018-01—2020-01在郑州市中心医院接受静脉溶栓治疗的急性缺血性脑卒中患者进行回顾性分析,通过单因素分析及二元Logistic回归分析静脉溶栓出血危险因素,绘制ROC曲线。结果纳入374例老年缺血性脑卒中患者,模型组262例,验证组112例。单因素分析结果显示年龄、性别、NIHSS评分、血糖、白细胞及D-二聚体是影响因素,Logistic回归分析显示性别(OR=2.181,P=0.003)、NIHSS评分(OR=0.932,P=0.001)、D-二聚体(OR=0.928,P=0.016)是老年缺血性脑卒中患者静脉溶栓后出血的独立危险因素,老年急性缺血性脑卒中患者静脉溶栓后出血预警模型ROC曲线下面积为0.718,95%CI 0.656~0.779,P<0.001。结论性别、NIHSS评分及D-二聚体是老年缺血性脑卒中患者静脉溶栓后出血的独立影响因素,利用影响因素构建的老年缺血性脑卒中患者静脉溶栓后出血预警模型预测能力具有良好的预测能力。
Objective The risk factors of intravenous thrombolysis hemorrhage in elderly patients with acute ischemic stroke were analyzed and a hemorrhage warning model was established.Methods Data of pa⁃tients with acute ischemic stroke receiving intravenous thrombolysis in Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2018 to January 2020 were retrospectively analyzed.Risk factors of hemor⁃rhage were analyzed by univariate analysis and binary Logistic regression,and ROC curves were drawn.Results A total of 374 elderly ischemic stroke patients were included,including 262 in the model group and 112 in the val⁃idation group.Univariate analysis showed that age,gender,NIHSS score,blood glucose,white blood cell and D-di⁃mer were the influencing factors.The results of Logistic regression showed that gender,NIHSS score and D-dimer were independent risk factors for bleeding after intravenous thrombolysis in elderly patients with acute ischemic stroke.The area under the ROC curve of the early-warning model for bleeding after intravenous thrombolysis in el⁃derly patients with acute ischemic stroke was 0.718,95%CI was 0.656-0.779,P<0.001.Conclusion Gender,NIHSS score and D-dimer are independent factors in elderly patients with ischemic stroke of bleeding after intrave⁃nous thrombolysis,the predict ability of early warning models in elderly patients with ischemic stroke of hemor⁃rhage after intravenous thrombolysis is good.
作者
杨瑞
鲁雪珍
YANG Rui;LU Xuezhen(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
出处
《中国实用神经疾病杂志》
2021年第23期2054-2063,共10页
Chinese Journal of Practical Nervous Diseases
关键词
急性缺血性脑卒中
静脉溶栓
阿替普酶
出血
预警模型
老年
Acute ischemic stroke
Intravenous thrombolysis
Alteplase
Hemoerrhage
Predictive model
Aged
