论文部分内容阅读
目的:探讨与对比心房颤动对不同时间窗内急性缺血性脑卒中患者静脉溶栓疗效的影响。方法:选择2014年8月到2016年5月在我院进行诊治的急性缺血性脑卒中患者98例,其中卒中前已诊断心房颤动定义为慢性心房颤动组(n=50),入院后诊断心房颤动者为新发心房颤动组(n=48);两组都给予重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗,记录两组预后情况。结果:两组患者的性别、年龄、时间窗、合并疾病、血糖与甘油三酯含量对比无明显差异(P>0.05)。慢性心房颤动组与新发心房颤动组的有效率分别为94.0%和95.8%,组间比较差异无统计学意义(P>0.05)。慢性心房颤动组与新发心房颤动组治疗后的m RS评分分别为6.22±1.83分和6.29±1.45分,都明显低于治疗前的9.24±1.31分和9.19±1.52分(P<0.05),组间对比无明显差异(P>0.05)。慢性心房颤动组的症状性脑出血与非症状性脑出血发生率分别为4.0%和2.0%,都明显低于新发心房颤动组的14.6%和12.5%(P<0.05)。结论:发病4.5h之内静脉溶栓急性缺血性脑卒中是安全有效的,新发心房颤动不影响患者静脉溶栓后的神经功能结局,但是会增加症状性脑出血与非症状性脑出血,需要加强预防性管理。
Objective: To investigate and compare the effect of atrial fibrillation on the efficacy of intravenous thrombolysis in patients with acute ischemic stroke in different time windows. Methods: A total of 98 patients with acute ischemic stroke who were diagnosed and treated in our hospital from August 2014 to May 2016 were selected. Among them, the diagnosis of atrial fibrillation before stroke was defined as chronic atrial fibrillation (n = 50) Atrial fibrillation was new-onset atrial fibrillation (n = 48). Both groups were given intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA), and the prognosis of both groups were recorded. Results: There were no significant differences in gender, age, time window, combined disease, blood glucose and triglyceride between the two groups (P> 0.05). The effective rates of chronic atrial fibrillation group and new-onset atrial fibrillation group were 94.0% and 95.8%, respectively, with no significant difference between the two groups (P> 0.05). The mRS scores of patients with chronic atrial fibrillation and those with new onset atrial fibrillation were 6.22 ± 1.83 and 6.29 ± 1.45, respectively, which were significantly lower than those of 9.24 ± 1.31 and 9.19 ± 1.52 before treatment (P <0.05) No significant difference between groups (P> 0.05). The incidences of symptomatic intracerebral hemorrhage and nonsymptomatic intracerebral hemorrhage in patients with chronic atrial fibrillation were 4.0% and 2.0%, respectively, which were significantly lower than those in patients with newly diagnosed atrial fibrillation (14.6% vs 12.5%, P <0.05). Conclusion: Intravenous thrombolytic acute ischemic stroke within 4.5 hours is safe and effective. New onset atrial fibrillation does not affect the neurological outcome after intravenous thrombolysis in patients, but it may increase the incidence of symptomatic intracerebral hemorrhage and nonsymptomatic intracerebral hemorrhage , There is a need to strengthen preventive management.