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急性缺血性脑卒中患者静脉溶栓治疗的转归 - 五年经验的回顾性和统计学分析。

Outcome in acute ischemic stroke patients treated with intravenous thrombolysis - a retrospective and statistical analysis of five years' experience.

机构信息

Department of Histology, University of Medicine and Pharmacy of Craiova, Romania;

出版信息

Rom J Morphol Embryol. 2024 Jul-Sep;65(3):449-455. doi: 10.47162/RJME.65.3.07.

Abstract

This paper represents a retrospective study on 252 patients with acute ischemic stroke (AIS), who received thrombolytic therapy between 2019-2023, in the Department of Neurology at the Emergency County Hospital in Craiova, Romania. We aimed to evaluate treatment complications and short-term outcomes of patients with AIS, treated with intravenous (i.v.) recombinant tissue plasminogen activator (rtPA; Alteplase), within 4.5 hours from onset. We also tried to assess the correlations between classical risk factors, such as diabetes, hypertension, atrial fibrillation, smoking and the outcome of these patients. Two hundred and fifty-two patients were treated with i.v. thrombolysis in our Department between October 2019 and December 2023. Out of the total thrombolysed patients, 146 were men and 106 were women. Our focus was on the clinical evolution of our patients and on the complications, especially on hemorrhagic transformation and death, and we tried to see if there were any correlations between gender, age, vascular risk factors such as diabetes, smoke, obesity, hypertension, atrial fibrillation and the outcome of our thrombolysed patients. Out of the total of 252 thrombolysed patients, only 55 (21.83%) had hemorrhagic transformation. Analyzing the differences between the occurrence of hemorrhagic transformation, respectively death, depending on the location and type of stroke, we did not identify statistically significant differences. The only comparison where a difference close to the significance limit is observed is that related to the frequency of deaths depending on the type of stroke - patients with cardioembolic stroke had a higher death rate.

摘要

这是一篇回顾性研究,共纳入 252 例于 2019 年至 2023 年在罗马尼亚克卢日-纳波卡紧急县医院神经内科接受溶栓治疗的急性缺血性卒中(AIS)患者。我们旨在评估发病 4.5 小时内接受静脉注射重组组织型纤溶酶原激活剂(rtPA;阿替普酶)治疗的 AIS 患者的治疗并发症和短期结局,并尝试评估经典危险因素(如糖尿病、高血压、心房颤动、吸烟)与这些患者结局之间的相关性。2019 年 10 月至 2023 年 12 月,我们科室共对 252 例患者进行了静脉溶栓治疗。在接受溶栓治疗的患者中,男性 146 例,女性 106 例。我们关注的重点是患者的临床转归和并发症,特别是出血性转化和死亡,并尝试观察性别、年龄、糖尿病等血管危险因素、吸烟、肥胖、高血压、心房颤动与溶栓患者结局之间是否存在相关性。在接受溶栓治疗的 252 例患者中,仅有 55 例(21.83%)发生出血性转化。分析出血性转化和死亡的发生与卒中部位和类型之间的差异,未发现统计学差异。仅在与卒中类型相关的死亡率比较中观察到接近显著性水平的差异,即心源性脑栓塞患者的死亡率较高。

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