脑梗死出血性并发症的相关危险因素及预后分析  

Analysis of relevant risk factors and prognosis of hemorrhagic complications of cerebral infarction

作　　者：黄渊智[1] 胡翠竹[2] 黄载文[1] 

机构地区：[1]广西壮族自治区钦州市第二人民医院神经内科,广西钦州535000 [2]广西壮族自治区钦州市第二人民医院普外科,广西钦州535000

出　　处：《实用临床医药杂志》2013年第7期33-35,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11320076)

摘　　要：目的分析脑梗死出血患者的并发症相关危险因素及预后。方法回顾性分析598例脑梗死患者的临床资料和影像学资料,其中40例出血性脑梗死患者为观察组,558例非出血性脑梗死患者为对照组。比较2组患者的一般资料、临床疗效、各检查指标及入院格拉斯哥昏迷评分(GCS)及神经功能缺损评分(NIHSS),并应用Logistic回归分析脑梗死出血性的并发症因素。结果 2组患者高胆固醇血症、心房颤动、尿蛋白阳性、梗死面积等指标比较差异有统计学意义;观察组总有效率显著低于对照组;观察组患者血小板计数、血糖、凝血酶原时间及入院NIHSS均显著小于对照组,但入院GCS显著高于对照组;Lo-gistic回归分析表明,梗死面积、尿蛋白阳性、应用抗凝药物、心房颤动、高胆固醇等指标是影响脑梗死出血并发症的主要因素。结论大面积脑梗死、应用抗凝药物、尿蛋白阳性、高胆固醇血症及心房颤动史是出血性脑梗死的主要危险因素,脑梗死出血性并发症由多因素、多机制共同作用导致,值得临床医生关注。Objective To analyze the complication- related risk factors and prognosis of pa- tients with cerebral infarction. Methods The clinical and imaging data of 598 patients with cere- bral infarction were retrospectively analyzed. Forty out of 598 patients had hemorrhagic cerebral in- farction and were considered as observation group. Another 559 patients had non - hemorrhagic cerebral infarction and were considered as control group. The general data, clinical effects, each ex- amination index and Glasgow coma score （GCS） and NIHSS at the time of being admitting to hospi- tal of patients in both groups were compared. Logistic regression analysis was used to analyze the factors of hemorrhagic complications of cerebral infarction. Results Compared with the hyperc- holesteremia, atrial fibrillation, positive urine protein and infarct size of the two groups, significant differences were presented. The total effectiveness rate of the observation group was significantly lower than that of the control group. Blood platelet count, blood glucose, prothrombin time and NIHSS at the time of being admitting to hospital of patients in the observation group were markedly smaller than those in the control group, while GCS notably higher than that in the control group. Logistic regression analysis demonstrated that the infarct size, positive urine protein, application of anticoagulant drugs, atrial fibrillation and hypercholesteremia were major factors to affect the hem- orrhagic complications of cerebral infarction. Conclusion Large - area infarct size, application of anticoagulant drugs, positive urine protein, atrial fibrillation and hypercholesteremia are major fac- tors of hemorrhagic cerebral infarction. The hemorrhagic complications of cerebral infarction were caused by mutual action of multiple factors and mechanisms, which deserves to be noticed by clinical doctors.

关 键 词：脑梗死 出血 并发症 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]