摘要
目的分析急性缺血性脑卒中降纤治疗出血性转化的危险因素。方法回顾性分析2012年1月-2015年12月在沈阳医学院附属中心医院进行降纤治疗的急性缺血性脑卒中患者225例临床资料,根据降纤治疗后复查头颅CT及MRI发现梗死部位出血分为出血性转化（HT）组,非出血性转化（非HT）组,对两组临床资料进行单因素和多因素分析。结果共34例发生出血性转化,发生率为15.11%,24例发生于降纤治疗后1周内,10例发生于第8-13天;中位时间4 d。因脑实质血肿死亡1例。HT组冠心病、房颤、大面积脑梗死、皮质梗死、心源性脑栓塞占比例明显高于非HT组,HT组入院时美国国立卫生研究院卒中量表（NIHSS）评分、空腹血糖、尿酸值明显高于非HT组,均与降纤治疗出血性转化有关,差异有统计学意义（P〈0.05）。结论房颤、大面积脑梗死、心源性脑栓塞、严重神经损害是急性缺血性脑卒中降纤治疗出血性转化的独立危险因素。
Objective To analyze the risk factors of hemorrhagic transformation in fibrinolytic therapy for acute ischemic stroke. Methods A retrospective analysis was conducted on the clinical data of 225 patients with acute ischemic stroke, who were treated with fibrinolytic therapy between January 2012 and December 2015 in affiliated central hospital of Shenyang medical college.According to infarction bleeding revealed by head CT / MRI after fibrinolytic therapy, patients were divided into hemorrhagic transformation（HT） group and non-hemorrhagic transformation（non-HT） group. Clinical data for two groups were analyzed with univariate and multivariate analysis. Results 34 patients suffered from hemorrhagic transformation（15.11% of all cases）： 24 cases occurred within 1 week after fibrinolytic therapy and 10 cases occurred in the first 8 to 13 days, with median time of 4 days; one patient died of hemorrhagic transformation. HT Group Incidences of coronary heart disease, atrial fibrillation,infarction,cortical infarction and cardiogenic cerebral embolism were significantly higher in HT group compared with non-HT group. Similarly,admission NIHSS score,fasting glucose,uric acid levels were significantly higher in HT group and were associated with fibrinolytic treatment of hemorrhagic transformation; the differences were statistically significant（P〈0.05）. Conclusion Atrial fibrillation,infarction,cortical infarction,cardiogenic cerebral embolism and severe nerve damage are independent risk factors for hemorrhagic transformation in fibrinolytic treatment.
出处
《中华保健医学杂志》
2016年第5期378-380,共3页
Chinese Journal of Health Care and Medicine
