老年急性前循环脑梗死病人静脉溶栓预后不良的危险因素及预测价值

doi:10.3969/j.issn.1003-9198.2022.10.011

Abstract

Abstract: Objective To investigate the risk factors of poor prognosis in the elderly patients with acute anterior circulation cerebral infarction(AACI) undergoing intravenous thrombolysis. Methods A total of 106 elderly patients with AACI who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in our hospital from January 2019 to May 2021 were enrolled. According to the score of modified Rankin scale (mRS) 3 months after the treatment, they were divided into good prognosis group (58 cases) (0-2 points) and poor prognosis group (48 cases) (3-6 points). The clinical data of the two groups were retrospectively analyzed.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the related factors for poor prognosis. Results Age, the incidence rate of atrial fibrillation, neutrophil to lymphocyte ratio (NLR), activated partial thromboplastin time(APTT), Alberta stroke program early CT score (DWI-Aspects), clot burden score (CBS), collateral circulation Tan score, baseline NIHSS score, and the incidence rate of early neurological deterioration (END) were significantly different between the two groups (P<0.05). Multivariate Logistic regression analysis suggested NLR(OR=1.426,95%CI:1.023-1.989, P=0.036), baseline NIHSS score (OR=1.144, 95%CI:1.020-1.284, P=0.022) and END(OR=25.818,95%CI:2.523-264.182, P=0.006) were the independent risk factors, while collateral circulation Tan score (OR=0.249, 95%CI:0.115-0.540, P<0.001) was a protective factor of poor prognosis.ROC curve analysis showed that the area under curve (AUC) of NLR, collateral circulation Tan score,baseline NIHSS score and END for predicting prognosis was 0.657,0.832,0.743 and 0.681 respectively. Conclusions There are many risk factors for poor prognosis in the elderly patients with AACI after intravenous thrombolysis. NLR, Tan score of collateral circulation, baseline NIHSS score and END before thrombolysis show good predictive value for prognosis.

Key words: cerebral infarction, intravenous thrombolysis, prognosis

CLC Number:

R743.3

WANG Wei, FANG Chuan-qin, CAO Lei, LIU Xue-yun. Risk factors of poor prognosis in elderly patients with acute anterior circulation cerebral infarction undergoing intravenous thrombolysis[J]. Practical Geriatrics, 2022, 36(10): 1019-1023.

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Risk factors of poor prognosis in elderly patients with acute anterior circulation cerebral infarction undergoing intravenous thrombolysis

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