The effect of estimated glomerular filtration rate on outcome of patients with acute ischemic stroke after intravenous thrombolysis with recombinant tissue plasminogen activator
10.3760/cma.j.issn.1006-7876.2018.04.006
- VernacularTitle:估算肾小球滤过率对急性缺血性卒中患者重组组织型纤溶酶原激活剂静脉溶栓结局的预测价值
- Author:
Hongfei PEI
1
;
Xu TONG
;
Ping YU
;
Huaguang ZHENG
;
Jing LIU
;
Jinghua LIU
;
Yueming TIAN
;
Nan SHI
;
Jingjing LI
;
Ying CUI
;
Yibin CAO
Author Information
1. 华北理工大学附属唐山市工人医院神经内科
- Keywords:
Brain ischemia;
Stroke;
Thrombolytic therapy;
Glomerular filtration rate;
Tissue plasminogen activator
- From:
Chinese Journal of Neurology
2018;51(4):268-274
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the association between estimated glomerular filtration rate (eGFR) and prognosis of acute ischemic stroke (AIS) patients who were treated by intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA).Methods We consecutively screened AIS patients who were treated by intravenous thrombolysis with rt-PA from January 2006 to September 2016 in Tangshan Gongren Hospital.According to eGFR value of patients at admission,the eligible patients were divided into two groups:normal eGFR group (eGFR ≥ 90 ml ? min-1 ? 1.73 m-2) and decreased eGFR group (eGFR ＜ 90 ml? min-1 ? 1.73 m-2).The incidence of symptomatic intracerebral hemorrhage (SICH),early neurological deterioration (END) at 24 hours and seven days after thrombolysis,mortality within seven days and 90 days,and excellent recovery at 90 days were compared between the two groups.The OR with 95％ CI and the adjusted OR with 95％ CI were analyzed by univariate and multivariate Logistic regression models.Results A total of 258 patients were enrolled,including 182 cases in the normal eGFR group and 76 cases in the decreased eGFR group.After adjusting for the potential confounders,multivariate Logistic regression analysis showed that the rates of SICH (13.2％ (10/76) vs 3.3％ (6/182),OR =3.859,95％ CI 1.313-11.341),END at 24 hours (21.1％ (16/76) vs 8.2％ (15/182),OR =2.958,95％ CI 1.347-6.495) and seven days (32.9％ (25/76) vs 12.6％ (23/182),OR =3.129,95％ CI 1.555-6.293),mortality within seven days (22.4％ (17/76) vs 6.0％ (11/182),OR =4.079,95％ CI 1.588-10.477) and 90 days (23.7％ (18/76) vs 9.9％ (18/182),OR =2.457,95％ CI 1.050-5.749) were higher in the decreased eGFR group than in the normal eGFR group.On the other hand,the chance of excellent recovery at 90 days (22.4％ (17/76) vs 43.4％ (79/182),OR =0.435,95％ CI 0.229-0.824) was less in the decreased eGFR group than in the normal eGFR group.Conclusion Decreased eGFR may not only increase the risks of SICH,END and death,but also reduce the chance of 90-day excellent recovery in AIS patients after intravenous thrombolysis with rt-PA.
