摘要目的 分析老年急性缺血性卒中患者阿替普酶静脉溶栓后早期神经功能改善相关的因素. 方法 回顾性分析发病4.5h内住院治疗的老年急性缺血性卒中患者,依据阿替普酶溶栓后早期神经功能是否有改善分为早期症状改善组和症状无改善组.采用多因素Logistic回归分析,以确定影响溶栓后早期神经功能改善的相关因素. 结果 共纳入118例患者,其中43例早期症状改善(36.44％).多因素Logistic回归分析显示:基线美国国立卫生研究院卒中量表(NIHSS)评分(OR=1.098,95％ CI=1.002～1.202,P=0.045)、入院血糖(OR=1.377,95％ CI=1.040～1.822,P=0.025)、心房颤动(OR =0.329,95％ CI=0.122～0.883,P=0.027)与溶栓后早期症状改善显著相关. 结论 基线NIHSS评分、入院血糖水平、心房颤动与老年急性缺血性卒中患者阿替普酶静脉溶栓后早期神经功能改善具有相关性.

abstractsObjective To analyze related factors for early neurological improvement after intravenous thrombolysis with alteplase in elderly patients with acute ischemic stroke (AIS).Methods Clinical data of elderly AIS patients with intravenous thrombolytic therapy within 4.5 hours of symptom onset were retrospectively analyzed.The demographic and clonical data were compared between improvement group and non-improvement group.Relevant factors for early neurological improvement after thrombolysis with a[teplase were analyzed by using multivariate logistic regression model.Results A total of 118 patients were included,of which 43 had early symptom improvement (36.44％).Multivariate logistic regression analysis showed that baseline NIHSS score(OR =1.098,95％CI=1.002-1.202,P=0.045),admission blood glucose(OR =1.377,95％CI=1.040-1.822,P =0.025),atrial fibrillation(OR =0.329,95 ％ CI =0.122-0.883,P =0.027) were significantly correlated with early symptom improvement after thrombolysis.Conclusions Baseline NIHSS score,admission blood glucose and atrial fibrillation are correlated with early neurological improvement after intravenous thrombolysis with alteptase in elderly AIS patients.