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接受溶栓治疗的缺血性中风患者的3个月结局;一项队列研究。

3-Month Outcome of Ischemic Stroke Patients Underwent Thrombolytic Therapy; a Cohort Study.

作者信息

Sari Aslani Payam, Rezaeian Shahab, Safari Elham

机构信息

Neurology Department, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Arch Acad Emerg Med. 2020 Jan 25;8(1):e6. eCollection 2020.

Abstract

INTRODUCTION

Reperfusion and neuroprotection are 2 main treatment strategies exist for management of patients with ischemic stroke. This study aimed to assess the 3-month outcome of patients who underwent thrombolytic therapy following ischemic stroke.

METHODS

In the present prospective cohort study, the 3-month outcome of patients (mortality, disability) with acute ischemic stroke admitted to neurology department an educational hospital, Kermanshah, Iran, from 2016 to 2019, who had received thrombolytic therapy was assessed. National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Score (MRS) were used for measuring the degree of disability (on admission, at the time of discharge and 3 months after thrombolytic therapy).

RESULTS

217 patients with the mean age of 66.40 ± 13.37 (27 - 97) years were studied (55.3% male). There was no significant correlation between decrease in NIHSS score and age (p = 0.44), sex (p = 0.082), time interval between initiation of symptoms (p = 0.104), and blood pressure on admission (p = 0.156). However, patients with blood sugar lower than 144 had better 3-month outcome (p = 0.045). Additionally, there was no significant correlation between the rate of decrease in MRS score and age (p = 0.813), sex (p = 0.875), time interval between initiation of symptoms (p = 0.495), and blood pressure on admission (p = 0.264). However, patients with blood sugar lower than 144 had better 3-month outcome (p = 0.022). 47 (21.7%) patient died and 170 (78.3%) were discharged. Mean age of the patients who died (73.70 ± 11.85 versus 64.39 ± 13.09 years; p < 0.0001) and their NIHSS score on admission (13.22 ± 6.01 versus 11.28 ± 5.70; p = 0.045) were significantly higher. In other words, the odds of mortality was 3.19 times in patients over 60 years of age (95% confidence interval (CI): 1.18 - 8.62) and 1.83 times in patients with NIHSS score over 12 (95% CI: 0.92 - 3.61).

CONCLUSION

There was no significant correlation between 3-month disabilities of stroke patients underwent thrombolytic therapy and age, sex, time from initiation of symptoms, or vital signs on admission. Patients with a blood sugar lower than 144 had better 3-month outcome.

摘要

引言

再灌注和神经保护是缺血性中风患者治疗的两种主要策略。本研究旨在评估缺血性中风后接受溶栓治疗患者的3个月预后。

方法

在本前瞻性队列研究中,对2016年至2019年在伊朗克尔曼沙赫一家教学医院神经内科住院的急性缺血性中风患者(死亡率、残疾情况)进行了评估,这些患者接受了溶栓治疗。采用美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(MRS)来测量残疾程度(入院时、出院时以及溶栓治疗后3个月)。

结果

研究了217例平均年龄为66.40±13.37(27 - 97)岁的患者(55.3%为男性)。NIHSS评分降低与年龄(p = 0.44)、性别(p = 0.082)、症状出现后的时间间隔(p = 0.104)以及入院时血压(p = 0.156)之间无显著相关性。然而,血糖低于144的患者3个月预后更好(p = 0.045)。此外,MRS评分降低率与年龄(p = 0.813)、性别(p = 0.875)、症状出现后的时间间隔(p = 0.495)以及入院时血压(p = 0.264)之间无显著相关性。然而,血糖低于144的患者3个月预后更好(p = 0.022)。47例(21.7%)患者死亡,170例(78.3%)出院。死亡患者的平均年龄(73.70±11.85岁对64.39±13.09岁;p < 0.0001)及其入院时的NIHSS评分(13.22±6.01对11.28±5.70;p = 0.045)显著更高。换句话说,60岁以上患者的死亡几率为3.19倍(95%置信区间(CI):1.18 - 8.62),NIHSS评分超过12分的患者为1.83倍(95%CI:0.92 - 3.61)。

结论

接受溶栓治疗的中风患者3个月的残疾情况与年龄、性别、症状出现时间或入院时生命体征之间无显著相关性。血糖低于144的患者3个月预后更好。

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