|本期目录/Table of Contents|

[1]陈鹭玲,陈星宇,彭锋.年龄对急性缺血性卒中溶栓治疗后发生不良事件的影响[J].慢性病学杂志,2020,21(08):1151-1154.
　CHENLu-ling *,CHENXing-yu,PENGFeng.Impact of age on adverse events in patients with acute ischemic stroke after receiving intravenous thrombolysis[J].,2020,21(08):1151-1154.
点击复制

年龄对急性缺血性卒中溶栓治疗后发生不良事件的影响

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:
21
期数:
2020年08期
页码:
1151-1154
栏目:
论　著
出版日期:
2020-08-28

文章信息/Info

Title:
Impact of age on adverse events in patients with acute ischemic stroke after receiving intravenous thrombolysis
作者:
陈鹭玲1; 陈星宇2; 彭锋2
厦门大学附属中山医院（1.老年科，2.神经内科），福建 厦门 361004
Author(s):
CHENLu-ling * ; CHENXing-yu; PENGFeng
*ZhongshanHospitalXiamenUniversity,Xiamen,Fujian361004,China Correspondingauthor:PENGFeng,E-mail:ppfeng@aliyun.com
关键词:
急性缺血性卒中; 静脉溶栓; 年龄; 卒中相关性肺炎
Keywords:
Acute ischemic stroke;  Intravenous thrombolysis;  Age;  Stroke-associated pneumonia
分类号:
R743.3
DOI:
-
摘要:
目的 探讨年龄与急性缺血性卒中（AIS）患者接受重组组织型纤溶酶原激活物（rt-PA）静脉溶栓后不 良事件，包括不良预后、症状性颅内出血和卒中相关性肺炎的关系。方法 回顾性分析2012年1月至2019年11 月厦门大学附属中山医院神经内科连续收治的AIS并接受rt-PA静脉溶栓患者临床资料。全部患者依据年龄分成四 组，包括≤50岁组，51~65岁组，66~80岁组，>80岁组。通过多因素logstic回归分析确定不良事件的影响因素。 结果 纳入479例rt-PA静脉溶栓的AIS患者，平均年龄（65.9±13.5）岁。单因素分析显示，四组患者出院时 不良预后、卒中相关性肺炎及在院死亡率比较，差异均有统计意义（均P<0.05）。多因素logistic回归分析发现， 与低龄组（<50岁）比较，高龄（>80岁）是出院时预后不良和卒中后相关性肺炎的独立危险因素，差异均有统 计学意义（均P<0.05）。结论 高龄与AIS患者接受静脉溶栓不良结局及卒中相关性肺炎密切相关。
Abstract:
Objective To investigate the correlation of age with adverse events, including adverse prog-nosis,symptomatic intracranial hemorrhage，stroke-associated pneumonia in patients with acute ischemic stroke undergoing intravenous thrombolysis using recombinant tissue plasminogen activator （rt-PA）. Methods A retrospective analysis was performed on consecutive patients with acute ischemic stroke receiving intravenous thrombolysis in department of neurology of Zhongshan Hospital Xiamen University from January 2012 to November 2019. All patients were classified into four groups: ≤50, 51-65, 66-80 and >80 years old. Multivariate logistic regression analysis was used to identify influence factors of adverse events. Results A total of479 patients with acute ischemic stroke using rt-PA were en-rolled, and their average age was（65.9±13.5）years. The rates of poor outcome at discharge, stroke-associated pneumonia and in-hospital mortality were significantly different among the four groups by univariate analysis，the differences were statistically significant (all P<0.05) . Multivariable logistic analy-sis showed that older（>80 years）was an independent risk factor for poor outcome at discharge and stroke-associated pneumonia in patients treated with rt-PA compared with the young age group（≤50 years），the differences were statistically significant (all P<0.05) . Conclusions Advanced age is asso-ciated with adverse prognosis and stroke-associated pneumonia in patients with acute ischemic stroke treated with intravenous thrombolysis by rt-PA.

参考文献/References:

[1] 胡永勤.人口性别和年龄变量对卒中发病的影响[J].中国慢性病 预防与控制,2012,20(4):485-486. [2] Yousufuddin M, Young N. Aging and ischemic stroke [J]. Aging (Albany NY),2019,11(9):2542-2544. [3] 孙文慧,李建彬,冯石献,等.2014-2017年郑州市居民卒中流行 病学特征分析[J].广东医学,2019,40(11):1584-1588. [4] Wang Y, Peng Q, Guo J,et al. Age-Period-Cohort Anal-ysis of Type-Specific Stroke Morbidityand Mortality in Chi-na [J]. Circ J,2020,84(4):662-669. [5] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学 组.中国急性缺血性卒中诊治指南2018[J].中华神经科杂志, 2018,51(9):666-682. [6] LorenzanoS, Vestri A, Bovi P,et al. Thrombolysis in el-derly stroke patients in Italy (TESPI) trial and updated meta- analysis of randomized controlled trials [J]. Int J Stroke,2019:1747493019884525. [7] 中华医学会神经病学分会脑血管病学组急性缺血性卒中诊治指 南撰写组.中国急性缺血性卒中诊治指南2010[J].中华神经科杂 志,2010,43(2):146-153. [8] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学 组.中国急性缺血性卒中诊治指南2014[J].中华神经科杂志, 2015,48(4):246-257. [9] Hacke W, Kaste M, Fieschi C,et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS Ⅱ) [J]. Lancet, 1998,352(9136):1245-1251. [10] Adams HP, Jr. Bendixen BH, Kappelle LJ,et al. Classifi-cation of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment [J]. Stroke, 1993,24(1): 35-41. [11] 中国卒中学会急救医学分会,中华医学会急诊医学分会卒中学 组,中国老年医学学会急诊医学分会,急救与创伤研究教育部重 点实验室.卒中相关性肺炎诊治中国专家共识(2019更新版)[J]. 中华急诊医学杂志,2019,28(12):1476-1484. [12] Yousufuddin M, Bartley AC, Alsawas M,et al. Impact of Multiple Chronic Conditions in Patients Hospitalized with Stroke and Transient Ischemic Attack [J]. J Stroke Cere-brovasc Dis,2017,26(6):1239-1248. [13] 吕晓培,滕振杰,袁帅,等.缺血性脑血管病微出血与白质病变的 相关性研究[J].中华行为医学与脑科学杂志,2017,26(11):999-1002. [14] 史艳,郭力,解庆凡,等.138例无症状性脑梗死患者临床特点及危 险因素分析[J].中华神经医学杂志,2015,14(7):655-660. [15] 中国培达预防卒中研究组.脑梗死患者脑白质病变及其危险因素 [J].中华神经科杂志,2007,40(3):182-186. [16] Rabinstein AA. Update on Treatment of Acute Ischemic Stroke [J]. Continuum (Minneap Minn), 2020,26(2):268-286. [17] Toni D, Lorenzano S, Agnelli G, et al. Intravenous thrombolysis with rt-PA in acute ischemic stroke patients aged older than 80 years in Italy [J]. Cerebrovasc Dis, 2008,25(1-2):129-135. [18] Sharma A, Sharma VK, Ahmad A, et al. Effect of Age on Arterial Recanalization and Clinical Outcome in Throm-bolyzed Acute Ischemic Stroke in CLOTBUST Cohort [J]. Ann Indian Acad Neurol, 2020,23(2):189-194.

备注/Memo

备注/Memo:
作者简介：陈鹭玲，大学本科，副主任医师，研究方向：老年卒中 通信作者：彭锋，E-mail: ppfeng@aliyun.com
更新日期/Last Update: 2020-08-28