急性脑梗死出血转化危险因素研究  

Risk Factors for Hemorrhagic Transformation after Acute Cerebral Infarction

作　　者：熊莉君[1] 张临洪[1] 

机构地区：[1]湖北省武汉市中心医院神经内科,430014

出　　处：《中国全科医学》2014年第15期1707-1709,1722,共4页Chinese General Practice

摘　　要：目的探讨急性脑梗死出血转化(HT)的相关危险因素。方法选取2011年6月—2013年6月在本院治疗的急性脑梗死患者818例,其中HT 135例(16.5%)(观察组),无HT 683例(83.5%)(对照组)。回顾性分析并比较两组患者的临床指标,经单因素t检验、χ2检验及非条件多因素Logistic回归分析,筛选急性脑梗死HT的相关危险因素。结果观察组患者糖尿病、冠心病、心房纤颤、空腹高血糖、蛋白尿、大面积脑梗死的发生率及空腹血糖水平均高于对照组(P<0.05),饮酒率低于对照组(P<0.05)。Logistic回归分析显示,糖尿病、心房纤颤、大面积脑梗死是急性脑梗死HT的独立危险因素(OR值分别为1.787、1.802和6.477,均P<0.05)。结论糖尿病、心房纤颤、大面积脑梗死是急性脑梗死HT的独立危险因素。Objective To explore the relevant risk factors for hemorrhagic transformation（HT） after acute cerebral infarction.Methods A total of 818 patients with acute cerebral infarction who were treated in our hospital from June 2011 to June 2013,were selected as study subjects,observation group included 135（16.5%） HT cases,control group included 683（83.5%） non- HT cases.Clinical indicators were analyzed retrospectively,and were compared between two groups.Univariate t- test,chi- square test and non- conditional Logistic regression analysis were performed to detect the relevant risk factors for HT after acute cerebral infarction.Results Prevalence of diabetes mellitus,coronary heart disease,atrial fibrillation,hyperglycemia,proteinuria,massive cerebral infarction and fasting glucose level in observation group were significantly higher than those in control group（P〈0.05）,but prevalence of drinking in observation group was significantly lower than that in control group（P〈0.05）.The results of multivariate Logistic regression analysis revealed that diabetes mellitus 〔OR = 1.787,95% CI（1.186,2.691）,P =0.005〕,atrial fibrillation 〔OR =1.802,95% CI（1.112,9.919）,P =0.017〕,and massive cerebral infarction 〔OR = 6.477,95% CI（4.198,9.991）,P = 0.000〕were independent risk factors for HT after acute cerebral infarction.Conclusion Diabetes mellitus,atrial fibrillation and massive cerebral infarction are the independent risk factors for HT after acute cerebral infarction.

关 键 词：脑梗死 出血转化 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]