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目的:对影响急性缺血性脑卒中患者应用尿激酶溶栓治疗预后的相关危险因素进行初步分析及研究,为今后选择适宜应用尿激酶溶栓的患者打下基础。方法:以2015年1月1日至2015年10月31日入院且应用尿激酶静脉溶栓的38例急性缺血性脑卒中患者,根据治疗3个月后的预后情况将患者分为A组(24例,预后良好)和B组(14例,预后不良),对两组患者的预后影响因素进行分析。结果:预后良好组患者的溶栓前NIHSS评分低于预后不良组,差异具有统计学意义(P<0.05)。多因素的Logistic回归分析显示,吸烟和HINSS评分与急性脑梗死尿激酶溶栓预后不良有关,差异具有统计学意义(P<0.05),且NIHSS评分是预后的独立预测因素。结论:尿激酶静脉溶栓治疗脑梗死的患者,溶栓前较高的NIHSS评分可能与溶栓预后不良有关。吸烟的患者溶栓后出现预后不良的几率是不吸烟患者溶栓后预后不良的8.83倍,溶栓前NIHSS评分每增加1分,溶栓预后不良的几率增加1.76倍。
OBJECTIVE: To preliminary analyze and study the related risk factors affecting the prognosis of patients with acute ischemic stroke treated by thrombolysis of urokinase, so as to lay the foundation for the future selection of patients suitable for urokinase thrombolysis. METHODS: Thirty-eight patients with acute ischemic stroke who were admitted to hospital from January 1, 2015 to October 31, 2015 and received intravenous thrombolysis with urokinase were divided into group A according to the prognosis of the patients after 3 months of treatment (24 patients with good prognosis) and group B (14 patients with poor prognosis). The prognostic factors of the two groups were analyzed. Results: The NIHSS score before thrombolysis in patients with good prognosis was lower than that in patients with poor prognosis, the difference was statistically significant (P <0.05). Multivariate Logistic regression analysis showed that smoking and HINSS scores were associated with poor prognosis of acute cerebral infarction with urokinase thrombolysis, the difference was statistically significant (P <0.05), and NIHSS score was an independent predictor of prognosis. Conclusion: In patients with cerebral infarction treated with intravenous thrombolytic therapy of urokinase, the higher NIHSS score before thrombolysis may be related to the poor prognosis of thrombolysis. The risk of poor prognosis after thrombolysis in smokers was 8.83 times worse than that in non-smokers after thrombolysis. The increase of NIHSS score 1 point before thrombolysis increased the odds of poor prognosis of thrombolysis by 1.76 times.