不同严重程度缺血性卒中患者静脉溶栓后失语改善情况分析

doi:10.3969/j.issn.1673-5765.2019.11.005

摘要/Abstract

摘要：

目的比较不同严重程度急性缺血性卒中（acute ischemic stroke，AIS）患者rt-PA静脉溶栓后失语改善的比例及程度。方法回顾性分析2015年4月-2017年3月在郑州人民医院神经内科卒中中心连续入院接受rt-PA静脉溶栓治疗的AIS患者360例，根据NIHSS评分分为NIHSS评分≤8分组和NIHSS评分＞8分组。收集两组患者的年龄、性别、高血压病史、糖尿病病史、心脏病病史、吸烟饮酒史、LDL-C、发病至溶栓时间等基线资料。比较两组患者溶栓24 h后神经功能显著好转、失语改善的比例差异，并比较两组失语改善程度的差异。结果共计纳入伴有失语的AIS患者158例，其中NIHSS评分≤8分患者49例，NIHSS评分＞8分患者109 例，两组基线资料及溶栓24 h后神经功能显著好转等指标差异无统计学意义；NIHSS评分≤8分组溶栓24 h后失语改善比例高于NIHSS评分＞8分组（67.3% vs 45.9%，P =0.021），NIHSS评分≤8分组失语完全改善比例高于NIHSS评分＞8分组（69.7% vs 44.0%，P =0.021）。结论伴有失语的AIS患者rt-PA静脉溶栓24 h后，NIHSS评分≤8分患者失语改善比例高于NIHSS评分＞8分患者。

文章导读： 通过比较不同严重程度缺血性卒中静脉溶栓患者的失语预后，提示失语在NIHSS评分＞8分时更加难以恢复。

关键词: 失语; 急性缺血性卒中; 静脉溶栓

Abstract:

Objective To investigate aphasia improvement after intravenous thrombosis in acute ischemic stroke patients with different severity. Methods Data of 360 acute ischemic stroke patients treated with rt-PA intravenous thrombolysis in Department of Neurology, Zhengzhou People’s Hospital from April 2015 to March 2017 were collected. Based on the NIHSS score on admission, all patients were divided into two groups: NIHSS≤8 group and NIHSS>8 group. The baseline data included age, sex, hypertension, diabetes, heart disease, smoking and drinking, low density lipoprotein cholesterol, onset-to-needle time and etc. Improvement of aphasia and neurological function between the two groups were compared. Results Finally, 158 patients with aphasia were included in this study, with 49 patients with NIHSS ≤8 and 109 patients with NIHSS >8. Baseline data and neurological function improvement at 24 h after thrombolysis between the two groups had no statistical difference. The improvement percentage of aphasia at 24 h after thrombolysis in NIHSS ≤8 group was higher than that in NIHSS >8 group (67.3% vs 45.9%, P =0.021). The complete improvement percentage of aphasia at 24 h after thrombolysis in NIHSS ≤8 group was higher than that in NIHSS >8 group (69.7% vs 44.0%, P =0.021). Conclusions For acute ischemic stroke patients with aphasia, the improvement percentage of aphasia in patients with NIHSS ≤8 was higher than that in patients with NIHSS >8 at 24 h after intravenous thrombolysis.

Key words: Aphasia; Acute ischemic stroke; Intravenous thrombolysis

付胜奇, 石宝洋, 张津, 宋良, 张洪涛, 张淑玲. 不同严重程度缺血性卒中患者静脉溶栓后失语改善情况分析[J]. 中国卒中杂志, 2019, 14(11): 1101-1105.

FU Sheng-Qi, SHI Bao-Yang, ZHANG Jin, SONG Liang, ZHANG Hong-Tao, ZHANG Shu-Ling. Analysis of Aphasia Improvement after Intravenous Thrombolysis in Stroke Patients with Different Severity[J]. Chinese Journal of Stroke, 2019, 14(11): 1101-1105.

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