急性脑梗死出血转化的临床及康复预后分析  

The clinical and rehabilitation prognostic analysis of hemorrhage transformation in acute ischemic stroke

作　　者：盛鑫[1] 张苏明[1] 黄晓江[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030

出　　处：《中国康复》2015年第1期17-18,共2页Chinese Journal of Rehabilitation

摘　　要：目的:探讨临床氯吡格雷联合拜阿司匹林治疗(双抗治疗)脑梗死并发出血转化(HT)患者的风险是否增高,以及尽早康复治疗对其预后的影响。方法:收集急性脑梗死患者654例,描述性分析HT发生率,观察双抗治疗是否增加HT发生的风险;在所有发生HT的55例患者中选取病情程度及年龄相当的对照组和观察组各15例,观察组患者经康复治疗,比较2组入院前及治疗14d后美国国立卫生研究院卒中量表(NIHSS)、改良的Rankin量表(mRS)评分。结果:在654例患者中,并发HT的患者共55例(8.41%),双抗的使用并不显著增加HT发生风险。康复治疗后,2组NIHSS评分均较治疗前明显降低(P<0.05),2组间比较差异无统计学意义。mRS评分比较,观察组较治疗前及对照组治疗后显著降低(P<0.05),而对照组较治疗前差异无统计学意义。结论:急性脑梗死中HT为急性脑梗死常见并可能影响预后的并发症之一,康复治疗对神经功能的恢复有一定积极意义。Objective：To study if the combined use of aspirin and clopidogrel increases the risk of hemorrhage transformation（HT）and the prognostic value of early rehabilitation treatment in ischemic stroke patients.Method：654patients with ischemic stroke were collected to descriptively analyze the rate of HT,and to observe if the combined use of aspirin and clopidogrel increased the HT risk.Thirty patients were screened in all 55 HT patients and divided into two groups according to the illness degree and age factors：15not subject to rehabilitation therapy as control group,and 15 subject to rehabilitation therapy as observation group.The national institute of health stroke scale（NIHSS）and modified Rankin scale（mRS）were compared in two groups before and 14 days after treatment.Results：HT occurred in 55 cases out of 654patients（8.41%）.The combined use of aspirin and clopidogrel could not increase the HT risk.NIHSS scores were significantly decreased in both groups after 14-day treatment（P〈0.05）without inter-group differences.The mRS scores were significantly increased after 14-day rehabilitation therapy in observation group as compared with the control group（P〈0.05）.Conclusion：HT is one of common complications in acute ischemic stroke possibly affecting the prognosis.Rehabilitation therapy can promote the neurological function recovery to some extent.

关 键 词：脑梗死 氯吡格雷联合拜阿司匹林治疗 出血转化 康复治疗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]