急性脑卒中溶栓后死亡影响因素临床研究

被引：6

作者：

林念童 ^{[1
]}

陈苓 ^{[2
]}

杨碧萍 ^{[1
]}

机构：

[1] 广州医科大学第一附属医院神经内科

[2] 广州医科大学第一附属医院放射科

来源：

实用医学杂志 | 2013年 / 29卷 / 17期

关键词：

卒中; 溶栓; 体温; 死亡率; 队列研究;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

摘要：

目的:探讨脑卒中溶栓后死亡影响因素。方法:采用Logistic回归模型的回顾性队列研究。筛选病例来源于2005年1月至2011年4月连续登记的急性缺血性脑卒中患者,入选标准:(1)出院诊断ICD-10编码为I63-I69;(2)住院期间均使用过阿替普酶治疗。临床变量包括人口学特征、生命体征、重要实验室、影像学和时间窗资料。临床结局变量为溶栓后3个月的死亡。结果:共筛选3 985例脑卒中病例,入选89例汉族患者,男40例(44.9%),女49例(55.1%);病死率为17.98%。高NIHSS评分(P=0.001,OR=1.48,95%CI 1.18～1.86)和体温升高(P=0.028,OR=4.60,95%CI 1.18～17.94)与死亡结局独立相关。结论:溶栓前较高的NIHSS评分和早期体温升高可能与溶栓后90 d病死率有关。

引用

页码：2861 / 2863

页数：3

共 11 条

[1] 第三次全国死因调查主要情况
[J]. 中国肿瘤, 2008, (05) : 344 - 345
[2] Risk Score for In-Hospital Ischemic Stroke Mortality Derived and Validated Within the Get With The Guidelines–Stroke Program[J] . Eric E. Smith,Nandavar Shobha,David Dai,DaiWai M. Olson,Mathew J. Reeves,Jeffrey L. Saver,Adrian F. Hernandez,Eric D. Peterson,Gregg C. Fonarow,Lee H. Schwamm. Circulation . 2010 (15)
[3] Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials[J] . Kennedy R Lees,Erich Bluhmki,Rüdiger von Kummer,Thomas G Brott,Danilo Toni,James C Grotta,Gregory W Albers,Markku Kaste,John R Marler,Scott A Hamilton,Barbara C Tilley,Stephen M Davis,Geoffrey A Donnan,Werner Hacke. The Lancet . 2010 (9727)
[4] Fever is associated with doubling of odds of short‐term mortality in ischemic stroke: an updated meta‐analysis[J] . K.Prasad,P. R.Krishnan. Acta Neurologica Scandinavica . 2010 (6)
[5] Effect of Hyperthermia on Prognosis After Acute Ischemic Stroke
Saini, Monica
Saqqur, Maher
Kamruzzaman, Anmmd
Lees, Kennedy R.
Shuaib, Ashfaq
[J]. STROKE, 2009, 40 (09) : 3051 - 3059
[6] Interleukin-1 receptor antagonist inhibits the release of glutamate, hydroxyl radicals, and prostaglandin E 2 in the hypothalamus during pyrogen-induced fever in rabbits[J] . Kuo-Feng Huang,Wu-Tein Huang,Kao-Chang Lin,Mao-Tsun Lin,Ching-Ping Chang. European Journal of Pharmacology . 2009 (1)
[7] Effects of IL-1β and IL-6 on tissue-type plasminogen activator expression in vascular endothelial cells
Larsson, Pia
Ulfhammer, Erik
Karlsson, Lena
Bokarewa, Maria
Wahlander, Karin
Jern, Sverker
[J]. THROMBOSIS RESEARCH, 2008, 123 (02) : 342 - 351
[8] Hyperthermia is a surrogate marker of inflammation-mediated cause of brain damage in acute ischaemic stroke
Leira, R.
Rodriguez-Yanez, M.
Castellanos, M.
Blanco, M.
Nombela, F.
Sobrino, T.
Lizasoain, I.
Davalos, A.
Castillo, J.
[J]. JOURNAL OF INTERNAL MEDICINE, 2006, 260 (04) : 343 - 349
[9] Hyperthermia masks the neuroprotective effects of tissue plaminogen activator
Noor, R
Wang, CX
Shuaib, A
[J]. STROKE, 2005, 36 (03) : 665 - 669
[10] Combination therapy of moderate hypothermia and thrombolysis in experimental thromboembolic stroke -: An MRI study
Kollmar, R
Henninger, N
Bardutzky, J
Schellinger, PD
Schäbitz, WR
Schwab, S
[J]. EXPERIMENTAL NEUROLOGY, 2004, 190 (01) : 204 - 212

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