上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

高血压病对急性缺血性卒中患者rt-PA静脉溶栓疗效的影响

蔡若蔚1，陈雅芳1，黄银辉2，林友榆2，张金英1，卓识途1，杨美丽1，许盈盈1，张碧月1   

  1. 1.福建医科大学附属第二医院神经内科， 泉州 362000； 2.晋江市医院神经内科， 晋江 362000
  • 出版日期:2014-11-28 发布日期:2014-12-02
  • 作者简介:蔡若蔚（1958—）， 男， 主任医师， 学士; 电子信箱: 251045413@qq.com。

Effects of hypertension on treatment of patients with acute ischemic stroke by rt-PA intravenous thrombolysis

CAI Ruo-wei1, CHEN Ya-fang1, HUANG Yin-hui2, LIN You-yu2, ZHANG Jin-ying1, ZHUO Shi-tu1, YANG Mei-li1, XU Ying-ying1, ZHANG Bi-yue1   

  1. 1.Department of Neurology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China; 2.Department of Neurology, Jinjiang City Hospital, Jinjiang 362000, China
  • Online:2014-11-28 Published:2014-12-02

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摘要：

目的 探讨高血压病对急性缺血性卒中患者重组组织型纤溶酶原激活剂（rt-PA）静脉溶栓疗效的影响。方法 收集2009年2月—2013年6月间发病4.5 h内给予rt-PA溶栓的急性缺血性卒中患者作为研究对象。采用改良Rankin量表(mRS)评价神经功能恢复状况，并根据mRS评分分为预后良好组(mRS评分0~1分)和预后不良组(mRS评分2~6分)。比较两组临床资料并进行危险因素分析。结果 预后良好组(n=92)与预后不良组(n=83)在高血压病比例方面的差异无统计学意义（66.30% vs 67.47%, P=0.870）。Logistic多因素回归分析结果显示：高血压病既不是症状性颅内出血的危险因素（OR=0.453, 95%CI：0.087~2.352，P=0.346），也不是影响溶栓预后的因素(OR=1.014；95%CI：0.933~1.101，P=0.746)。结论 高血压病对急性缺血性卒中患者静脉溶栓疗效无明显影响。

关键词: 高血压病, 急性缺血性卒中, 重组组织型纤溶酶原激活剂

Abstract:

Objective To explore the effects of hypertension on the treatment of patients with acute ischemic stroke by recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis.MethodsPatients with acute ischemic stroke who were administrated intravenous rt-PA within 4.5 h after the onset were selected. The onset time was between February 2009 and June 2013. Modified Rankin Scale (mRS) was used to evaluate the recovery of neurological functions. Patients were divided into the good prognosis group (mRS scores were 0-1) and poor prognosis group (mRS scores were 2-6) according to the scores of mRS. General informations of patients were collected and compared between two group and risk factors were analyzed. Results The difference of the percentage of patients with hypertension of the good prognosis group (n=92) and poor prognosis group (n=83) was not statistically significant (66.30% vs 67.47%，P=0.870). The results of logistic multivariate regression analysis showed that hypertension was neither a risk factor of symptomatic intracranial hemorrhage (OR=0.453, 95%CI: 0.087-2.352, P=0.346) nor a influencing factor of the prognosis of thrombolysis (OR=1.014, 95%CI: 0.933-1.101, P=0.746). Conclusion The hypertension has no significant effect on the treatment of patients with acute ischemic stroke by rt-PA intravenous thrombolysis.

Key words: hypertension, acute ischemic stroke, recombinant tissue plasminogen activator