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急性缺血性脑卒中患者静脉溶栓后早期神经功能 恶化的影响因素及G-FAST评分的预测价值
史宝光董蕾蕾赵丹陈莉莉
()
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目的 探讨急性缺血性脑卒中(AIS)患者阿替普酶静脉溶栓后早期神经功能恶化(END) 的影响因素及凝视 - 面 - 臂 - 言语 - 时间(G-FAST)评分的预测价值。方法 回顾性分析 2016 年 1 月 至 2019 年 1 月沈阳医学院附属第二医院收治并采用阿替普酶静脉溶栓治疗的 219 例 AIS 患者。用美国 国立卫生研究院卒中量表(NIHSS)评估静脉溶栓治疗后 END 的发生情况。Logistic 回归分析影响 END 的因素;受试者工作特征(ROC)曲线分析各指标预测 END 的价值。结果 219 例患者中 43 例患者发 生 END,占 19.63%。年龄≥ 60 岁(OR=1.035,95%CI:1.003~1.236)、心房颤动病史(OR=1.925,95%CI: 1.313~2.685)、昏 迷(OR=2.031,95%CI:1.340~3.026)、入 院 时 NIHSS 评 分 ≥ 10 分(OR=1.368,95%CI: 1.167~2.361)及入院时 G-FAST 评分≥ 3 分(OR=1.509,95%CI:1.368~3.165)是 END 发生的独立危险因 素(P< 0.05)。G-FAST 评分和 NIHSS 评分及二者联合预测 END 的 ROC 曲线下面积分别为 0.768、0.733 和0.897。结论 阿替普酶静脉溶栓后END 发生的影响因素较多,G-FAST量表对END 有一定预测价值。
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Influence factors of the early deterioration of neurological function after intravenous thrombolysis and the predictive value of G-FAST score in patients with acute ischemic stroke
Shi Baoguang, Dong Leilei, Zhao Dan, Chen Lili
()
Abstract:
Objective To explore the influence factors of early neurological deterioration (END) after intravenous thrombolysis with alteplase and the predictive value of gaze face arm speech time (G-FAST) score in patients with acute ischemic stroke (AIS). Methods A total of 219 patients with AIS treated with alteplase for intravenous thrombolysis in the Second Affiliated Hospital of Shenyang Medical College from January 2016 to January 2019 were retrospectively analyzed. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the incidence of END after intravenous thrombolysis with alteplase. Logistic regression was used to analyze the influencing factors of END, and receiver operating characteristic (ROC) curve was used to analyze the value of each indicator to predict END. Results Among the 219 patients, 43 patients had END, accounting for 19.63%. Age ≥ 60 (OR=1.035,95%CI:1.003-1.236), history of atrial fibrillation (OR=1.925,95%CI: 1.313-2.685), coma (OR=2.031,95%CI:1.340-3.026), NIHSS score ≥ 10 (OR=1.368,95%CI:1.167-2.361) and G-FAST score ≥ 3 (OR=1.509,95%CI:1.368-3.165) were independent risk factors for END (P< 0.05). G-FAST score, NIHSS score and the area under ROC curve combined predicted by them were 0.768, 0.733 and 0.897, respectively. Conclusions There are many factors influencing the occurrence of END after intravenous thrombolysis with alteplase. G-FAST scale has certain predictive value for END.

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