卒中预警综合征患者的静脉溶栓:与抗血小板治疗的比较
Intravenous thrombolysis in patients with stroke warning syndrome:comparison with antiplatelet therapy
朱可 1李艳艳 1李建瑞 1樊新红 1李金燕 1樊同 1郭丹2
作者信息
- 1. 兵器工业五二一医院神经内科,西安 710065
- 2. 北部战区总医院第一派驻门诊部,沈阳 110002
- 折叠
摘要
目的 探讨静脉溶栓与抗血小板治疗在卒中预警综合征(stroke warning syndrome,SWS)患者中的有效性及安全性以及SWS患者转归的影响因素.方法 回顾性纳入2018年6月1日至2023年12月31日兵器工业五二一医院收治的SWS患者.部分患者给予阿替普酶静脉溶栓,然后进行口服抗血小板治疗;部分患者仅接受抗血小板治疗.主要观察指标为发病后90 d时改良Rankin量表评分,0～2分定义为转归良好.结果 共纳入35例SWS患者,男性26例(74.3％),年龄(58.29± 11.06)岁.19例(54.3％)接受静脉溶栓,27例(77.1％)90d时转归良好.静脉溶栓组与仅抗血小板治疗组人口统计学、基线资料以及转归良好均差异无统计学意义.静脉溶栓组有l例出现新发卒中,1例出现短暂性脑缺血发作.转归良好组与转归不良组ABCD2评分、收缩压、低密度脂蛋白胆固醇、空腹血糖、发作时最高美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分以及症状持续时间差异有统计学意义(P均＜0.05).结论 静脉溶栓与仅抗血小板药治疗SWS的效果相近.ABCD2评分、收缩压、低密度脂蛋白胆固醇、空腹血糖、发作时最高NIHSS评分以及症状持续时间可能是SWS患者转归的影响因素.
Abstract
Objective To investigate the efficacy and safety of intravenous thrombolysis and antiplatelet therapy in patients with stroke warning syndrome(SWS),as well as influencing factors of the outcome in patients with SWS.Method Patients with SWS admitted to the 521st Hospital of Ordnance Group from June 1,2018 to December 31,2023 were retrospectively included.Some patients were treated with ateplase intravenous thrombolysis,followed by oral antiplatelet therapy;some patients only received antiplatelet therapy.The main outcome measure was the modified Rankin Scale score at 90 days after onset,with a score of 0-2 defined as good outcome.Results A total of 35 patients with SWS were included,including 26 males(74.3％)with an age of 58.29±11.06 years.Nineteen patients(54.3％)received intravenous thrombolysis,and 27(77.1％)had good outcome at 90 days.There was no statistically significant difference in demographic,baseline data,and good outcome between the intravenous thrombolysis group and the antiplatelet therapy group.One patient had new stroke and one had transient ischemic attack in the intravenous thrombolysis group.There were statistically significant differences in ABCD2 score,systolic blood pressure,low-density lipoprotein cholesterol,fasting blood glucose,highest National Institutes of Health Stroke Scale(NIHSS)score at onset,and symptom duration between the good outcome group and the poor outcome group(all P＜0.05).Conclusions The efficacy of intravenous thrombolysis is similar to that of antiplatelet drugs alone in treating SWS.ABCD2 score,systolic blood pressure,low-density lipoprotein cholesterol,fasting blood glucose,highest NIHSS score at onset,and duration of symptoms may be influencing factors for the outcome of patients with SWS.
关键词
脑缺血发作,短暂性/脑梗死/血栓溶解疗法/抗血小板聚集药/磁共振成像/治疗结果Key words
Ischemic attack,transient/Cerebral infarction/Thrombolytic therapy/Platelet aggregation inhibitors/Magnetic resonance imaging/Treatment outcome引用本文复制引用
基金项目
辽宁省自然科学基金(2020-MS-13)
辽宁省自然科学基金(2021-MS-043)
出版年
2024
NETL
NSTL
万方数据