急性脑梗死溶栓后出血性转换的影响因素分析  

Influential Factors of Hemorrhagic Transformation after Thrombolysis in Patients with Acute Cerebral Infarction

作　　者：李凤鹏[1] 周中和[1] 王而强[1] 张子非[1] 郝维军[1] 邢大江 韩雅玲[2] 陈会生[1] 

机构地区：[1]沈阳军区总医院神经内科,沈阳110840 [2]沈阳军区总医院心血管内科,沈阳110840

出　　处：《解放军医药杂志》2014年第4期11-13,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：科技部重大新药创制创新药物研究开放技术平台建设(2012ZX0903016-002)

摘　　要：目的 探讨急性脑梗死溶栓后出血性转换（hemorrhagic transformation,HT）的影响因素.方法 对2012年3月-2013年5月收治的43例急性脑梗死患者溶栓后24 -48 h复查头CT,根据有无脑出血分为无HT组和HT组.对两组性别、高血压病、糖尿病、房颤、脑白质疏松、年龄、溶栓前美国国立卫生院卒中量表（national institute of health stroke scale,NIHSS）评分、溶栓前收缩压、溶栓前舒张压和溶栓前血糖10项可能影响溶栓后HT的因素进行Logistic回归分析.结果 本组溶栓后HT发生率为16.28％,房颤是影响急性脑梗死溶栓后HT的危险因素（OR=15.50;95％CI：2.34,102.85;P =0.005）.结论 对伴发房颤的急性脑梗死患者进行溶栓发生HT的风险增高.Objective To explore the influential factors related to hemorrhagic transformation （HT） after throm- bolysis in patients with acute cerebral infarction. Methods Head CT was double checked in 43 patients with acute cere- bral infarction within 24-48 h after thrombolysis during March 2012 and May 2013, and the patients were divided into non-HT group and HT group according to CT results. The possible influential factors of HT by gender, hypertension histo- ry, and history of diabetes mellitus, fibrillation atrial, leukoareosis, age, the scores of national institute of health stroke scale （NIHSS） , systolic pressure, diastolic pressure and serum glucose before thrombolysis in the two groups were per- formed through logistic regression analysis. Results The incidence rate of HT after thrombolysis was 16. 28%. Fibrilla- tion atrial was the risk factor, which could influence HT after thrombolysis in patients with acute cerebral infarction （OR = 15.50; 95% CI： 2.34,102.85; P =0.005）. Conclusion Patients with acute cerebral infarction complicated by fibrillation atrial have a higher risk factor of HT.

关 键 词：脑梗死 溶栓 出血性转换 心房颤动 

分 类 号：R743.33[医药卫生—神经病学与精神病学]