摘要
目的探讨D-二聚体(D-D)、纤维蛋白原(Fib)水平与急性缺血性脑卒中(AIS)继发脑出血的关系。方法选取2018年1月至2022年1月接受溶栓治疗的153例AIS患者为研究对象,依据溶栓后24 h内或在出现临床症状恶化时颅脑计算机断层扫描(CT)复查是否发现出血性病灶将其分为出血组(39例)和非出血组(114例)。评价及测定相关指标,分析AIS继发脑出血的影响因素。结果溶栓后患者的美国国立卫生研究院卒中量表(NIHSS)评分、白细胞计数、血红蛋白、D-D、Fib水平低于溶栓前(P<0.05)。单因素分析结果显示,两组的脑卒中部位、大面积梗死、发病至溶栓时间比较,差异具有统计学意义(P<0.05);溶栓前,出血组的NIHSS评分高于非出血组(P<0.05);溶栓后,出血组的NIHSS评分高于非出血组,D-D和Fib水平低于非出血组(P<0.05)。Logistic回归分析结果显示,大面积梗死、发病至溶栓时间延长、溶栓前后NIHSS评分高是AIS继发脑出血的危险因素,溶栓后D-D、Fib水平高是AIS继发脑出血的保护因素(P<0.05)。结论溶栓后D-D、Fib水平与AIS继发脑出血密切相关,溶栓后D-D、Fib水平高是AIS继发脑出血的保护因素。
Objective To investigate the relationship between D-dimer(D-D),fibrinogen(Fib)levels and cerebral hemorrhage secondary to acute ischemic stroke(AIS).Methods A total of 153 patients with AIS received thrombolytic therapy from January 2018 to January 2022 were selected as the study subjects.According to whether hemorrhagic lesions were found within 24 h after thrombolysis or brain computed tomography(CT)when clinical symptoms deteriorated,the patients were divided into bleeding group(39 cases)and non-bleeding group(114 cases).The related indexes were evaluated and measured,and the influencing factors of cerebral hemorrhage secondary to AIS were analyzed.Results The National Institutes of Health Stroke Scale(NIHSS)score,white blood cell count,hemoglobin,D-D and Fib levels of patients after thrombolysis were lower than those before thrombolysis(P<0.05).The univariate analysis results showed that there were statistically significant differences in stroke location,large area infarction and time from onset to thrombolysis between the two groups(P<0.05);before thrombolysis,the NIHSS score of the bleeding group was higher than that of the non-bleeding group(P<0.05);after thrombolysis,the NIHSS score of the bleeding group was higher than that of the non-bleeding group,while the D-D and Fib levels were lower than those of the non-bleeding group(P<0.05).Logistic regression analysis results showed that large area infarction,prolonged time from onset to thrombolysis and high NIHSS score before and after thrombolysis were risk factors for cerebral hemorrhage secondary to AIS,and high levels of D-D and Fib after thrombolysis were protective factors for cerebral hemorrhage secondary to AIS(P<0.05).Conclusion The levels of D-D and Fib after thrombolysis are closely related to cerebral hemorrhage secondary to AIS,and the high levels of D-D and Fib after thrombolysis are protective factors of cerebral hemorrhage secondary to AIS.
作者
王建峰
刘花利
张礼
WANG Jianfeng;LIU Huali;ZHANG Li(the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Shaanxi Kangfu Hospital,Xi'an 710065;Xi'an International Medical Center Hospital,Xi'an 710100,China)
出处
《临床医学研究与实践》
2023年第26期1-4,共4页
Clinical Research and Practice
基金
西安国际医学中心医院院级科研课题(No.KY20210711)。
