急性缺血性脑卒中患者在印度北部三级医院治疗窗口的临床病因学概况

A. Chandra, Maqbool Wani, A. Raina, Hilal Ganie, W. Dar, Arjimand Yaqoob, Ravouf Asimi
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摘要

背景:脑卒中的定义是临床症状的迅速出现,重点关注证据(适用于深度昏迷和蛛网膜下腔出血的个体)或广泛的脑损伤。本研究旨在评估印度北部三级医院急性缺血性脑卒中患者的临床特征。方法:通过对病例资料的分析和对患者的访谈,收集和评价患者的信息。该研究的纳入和排除标准基于2018年美国心脏协会和美国卒中协会(AHA/ASA)急性缺血性卒中溶栓指南。排除近期重大外伤或14天内不涉及头部的大手术、卒中发作时癫痫发作、全身性恶性肿瘤和妊娠。结果:该研究招募了76名患者,他们被分为两组。一组患者给予替奈普酶,另一组患者给予阿替普酶。替奈普酶组和阿替普酶组患者年龄不同,有高血压、房颤、糖尿病、吸烟、既往卒中或短暂性脑缺血发作等危险因素。两组高血压、舒张压等危险因素分布差异有统计学意义(P < 0.05)。42名替普酶组患者中有3名出现颈内动脉卒中,32名替普酶组中有2名出现颈内动脉卒中。两组中的大多数患者都发生了原因不明的中风。小血管和大血管中风分别占9.5%和14.7%。结论:在脑卒中的发展过程中,年龄和性别有一定的关系。久坐不动的生活方式、饮食和肥胖是中风的危险因素。根据AHA/ASA药物使用分析,大多数药物适用于脑卒中患者。
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Clinicoetiological profile of acute ischemic stroke patients in the therapeutic window in a tertiary care hospital in Northern India
Background: A stroke is defined by the rapid emergence of clinical symptoms and focuses on evidence (applicable to individuals in a deep coma and those with subarachnoid hemorrhage) or widespread brain damage. The study aimed to evaluate the clinical characteristics of patients with acute ischemic stroke in a tertiary care hospital in North India. Methods: By analyzing case files and conducting patient interviews, information on the patients was gathered and evaluated. The study's inclusion and exclusion criteria were based on the 2018 American Heart Association and American Stroke Association (AHA/ASA) thrombolysis guidelines for acute ischemic stroke. Recent major trauma or major surgery within 14 days not involving the head, seizure at the onset of stroke, systemic malignancy, and pregnancy were excluded. Results: The study enlisted the participation of 76 patients who were divided into two groups. Patients in the one group were given tenecteplase, whereas the other group were given alteplase. Patients in the tenecteplase and alteplase groups were of different ages and had various other risk factors for hypertension, atrial fibrillation, diabetes, smoking, and previous stroke or transient ischemic attack. The risk factor distribution in both the groups was statistically significant for variables such as hypertension and diastolic blood pressure (P < 0.05). Stroke in internal carotid artery territory was present in 3 out of 42 in the tenecteplase group and 2 out of 32 in the alteplase group. Most patients in both the groups had a stroke of undetermined cause. Small vessel and large vessel strokes were found in 9.5% and 14.7%, respectively. Conclusion: In the development of stroke, there is a definite relationship between age and gender. A sedentary lifestyle, food, and obesity are risk factors for stroke. According to an AHA/ASA drug utilization analysis, most medicines were appropriate for stroke patients.
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