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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >The Effect of Physiologic Derangement in Patients with Stroke Treated with Thrombolysis
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The Effect of Physiologic Derangement in Patients with Stroke Treated with Thrombolysis

机译：溶栓治疗对中风患者的生理紊乱的影响

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Background: Body temperature, blood glucose, and blood pressure (BP) may interfere with outcome in patients with acute ischemic stroke treated with thrombolysis. Methods: We prospectively studied 127 patients who received thrombolysis with tissue plasminogen activator for acute stroke in Bergen, Norway. Body temperature, blood glucose, and BP were measured before thrombolysis. Maximum body temperature and maximum blood glucose within the first 5 days after thrombolysis and maximum BP within the first 24 hours after thrombolysis were measured. The outcome was measured with modified Rankin scale score obtained at 3 months after stroke onset. Variables were tested using multiple logistic regression analysis after adjusting for National Institute of Health Stroke Scale score before thrombolysis and potential confounders. Results: The average age of the patients was 63 years and the median National Institute of Health Stroke Scale score was 13. On admission, diabetes mellitus was present in 6% of patients and hypertension in 51% of patients. High body temperature and high blood glucose after thrombolysis were associated with poor prognosis (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.29-6.25, P = .01; OR 1.33, 95% CI 1.02-1.74, P = .03). High body temperature and high blood glucose before thrombolysis were not associated with outcome (OR 0.79, 95% CI 0.39-1.58, P = .5; OR 1.04, 95% CI 0.75-1.20, P = .08). High systolic BP both before and after thrombolysis was associated with poor outcome (OR 1.27, 95% CI 1.03-1.52, P = .025; OR 1.22, 95% CI 1.00-1.44, P = .045). High diastolic BP both before and after thrombolysis was not associated with outcome (OR 1.03, 95% CI 0.97-1.36, P =.85; OR 1.16, 95% CI 0.99-1.46, P = .29). Conclusions: The current study indicates that in patients with ischemic stroke, high body temperature and high blood glucose after thrombolysis are associated with poor prognosis. Frequent monitoring of these parameters and the appropriate treatment of it, if elevated, are important during the first few days after thrombolysis. High systolic BP both before and after thrombolysis was associated with poor outcome. This finding may support the practice of reducing systolic BP below 185 mm Hg both before and after thrombolysis.
机译：背景：体温，血糖和血压（BP）可能会干扰溶栓治疗的急性缺血性中风患者的预后。方法：我们在挪威卑尔根市对127例接受组织纤溶酶原激活剂溶栓治疗的急性卒中患者进行了前瞻性研究。溶栓前测量体温，血糖和血压。测量溶栓后前5天内的最高体温和最大血糖，溶栓后24小时内的最大BP。用卒中后3个月获得的改良兰金量表评分测量结局。调整溶栓前的美国国立卫生研究院卒中量表评分和潜在的混杂因素后，使用多元逻辑回归分析测试变量。结果：患者的平均年龄为63岁，美国国立卫生研究院卒中量表的中位数为13。入院时，有6％的患者患有糖尿病，而51％的患者患有高血压。溶栓后体温升高和血糖升高与预后不良相关（优势比[OR] 2.84，95％置信区间[CI] 1.29-6.25，P = 0.01;或1.33，95％CI 1.02-1.74，P = .03）。溶栓前的体温升高和高血糖与预后无关（OR 0.79，95％CI 0.39-1.58，P = .5; OR 1.04，95％CI 0.75-1.20，P = .08）。溶栓前后的高收缩压与不良预后相关（OR 1.27，95％CI 1.03-1.52，P = .025; OR 1.22，95％CI 1.00-1.44，P = .045）。溶栓前后高舒张压与预后无关（OR 1.03，95％CI 0.97-1.36，P = .85; OR 1.16，95％CI 0.99-1.46，P = .29）。结论：目前的研究表明，在缺血性中风患者中，溶栓后体温升高和血糖升高与预后不良有关。在溶栓后的头几天，经常监测这些参数并进行适当的治疗（如果升高）很重要。溶栓前后的高收缩压与不良预后相关。这一发现可能支持在溶栓之前和之后将收缩压降低到185 mm Hg以下的实践。

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