尿激酶静脉溶栓治疗急性缺血性卒中/短暂性脑缺血发作的院内死亡率及相关影响因素的多中心分析

目的 探讨尿激酶静脉溶栓治疗急性缺血性卒中/TIA患者的院内死亡率及其影响因素。
方法 回顾性分析2013年1月-2016年5月河南省11家市级、县级医院神经内科连续收治的发病6 h内
接受尿激酶静脉溶栓治疗的急性缺血性卒中和TIA患者的临床资料，统计院内全因死亡率，采用多因
素Logistic回归分析院内死亡的相关影响因素。
结果 共入组444例患者，平均年龄60.19±11.61岁，男性296例（66.7%），院内死亡25例（5.6%）。多
因素Logistic回归分析显示，发病至溶栓时间3～6 h（OR 3.006，95%CI 1.120～8.071，P =0.029）、溶栓前
NI HSS评分（OR 1.130，95%CI 1.079～1.183，P＜0.001）及心房颤动病史（OR 3.671，95%CI 1.282～10.511，
P =0.015）是尿激酶静脉溶栓治疗急性缺血性卒中/TIA患者院内死亡的独立影响因素。
结论 发病至溶栓时间3～6 h、严重神经功能损害、心房颤动病史是尿激酶静脉溶栓治疗急性缺
血性卒中/TIA患者住院期间死亡的独立危险因素。

Inhospital Mortality and Related Influencing Factors in Acute Ischemic Stroke Patients Treated with Urokinase Intravenous Thrombolysis

Objective To investigate the inhospital mortality and related risk factors in patients with acute
ischemic stroke (AIS) or TIA who received urokinase intravenous thrombolysis.
Methods The data of AIS and TIA patients who received urokinase intravenous thrombolysistreatment within 6 hours after onset from 11 hospitals in Henan province were retrospectively
analyzed. Baseline data and inhospital mortality were collected. Multivariate logistic regression
analysis was used to identify the independent risk factors for inhospital death.
Results A total of 444 patients were included, with a mean age of 60.19±11.61 years old and
296 males (66.7%). There were 25 (5.6%) inhospital deaths. Multivariate analysis showed that
thrombolysis in the 3-6 hour time window (OR 3.006, 95%CI 1.120-8.071, P =0.029), NIHSS score
at admission (OR 1.130, 95%CI 1.079-1.183, P <0.001), atrial fibrillation (OR 3.671, 95%CI 1.282-
10.511, P =0.015), were independent risk factors for inhospital death after urokinase thrombolysis.
Conclusions Intravenous thrombolysis in the 3-6 hour time window, NIHSS score at admission,
atrial fibrillation were independent risk factor for inhospital death after urokinase intravenous
thrombolysis in AIS/TIA patients.