华法林相关性颅内出血与高血压相关性颅内出血的对比研究  

Comparative Study of Warfarin and Hypertension Related Intracranial Hemorrhage

作　　者：袁鹏[1] 毕齐[1] 刘水平[1] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,北京100029

出　　处：《中国药房》2015年第9期1170-1173,共4页China Pharmacy

摘　　要：目的:比较华法林相关性颅内出血(ICH)与高血压相关性ICH的临床特点,为其预防和治疗提供参考。方法:回顾性收集2010年1月-2014年10月我院322例ICH患者资料,其中华法林相关性ICH组患者58例(INR≤3的低强度抗凝组16例,INR>3的高强度抗凝组42例),高血压相关性ICH组患者264例,比较华法林相关性ICH组与高血压相关性ICH组患者的性别、年龄、出血量、出血部位和院内死亡率,并比较华法林相关性ICH低强度抗凝组与高强度抗凝组患者的发病率、出血量和院内死亡率。结果:华法林相关性ICH组的男性患者较高血压相关性ICH组少(53.4%vs.64.7%,P<0.05),患者年龄较高血压相关性ICH组大[(67.5±19.4)岁vs.(61.9±15.8)岁,P<0.05],平均出血量显著多于高血压相关性ICH组[(55±24)ml vs.(26±19)ml,P<0.05],脑叶出血患者较高血压相关性ICH组多(50.0%vs.11.7%,P<0.05),基底节出血较高血压相关性ICH组少(25.9%vs.54.2%,P<0.05),院内死亡率较高血压相关性ICH组高(48.3%vs.13.6%,P<0.05);华法林相关性ICH高强度抗凝组患者相比低强度抗凝组发病率(72.4%vs.27.6%,P<0.05)、平均出血量[(59±29)ml vs.(32±13)ml,P<0.05]及院内死亡率(59.5%vs.18.8%,P<0.05)均显著增加。结论:华法林相关性ICH较高血压相关性ICH在性别、年龄、出血量、出血部位及院内死亡率方面均有显著差异,且抗凝强度显著影响ICH患者的发病率、出血量和院内死亡率。OBJECTIVE：To compare the clinical characteristics of the warfarin related intracranial haemorrhage（ICH）and hypertension related ICH,and provide reference for the prevention and treatment. METHODS：322 cases in patients with ICH from Jan. 2010 to Oct. 2014 in our hospital were retrospectively collected,including 58 cases with warfarin related ICH（16 cases in low intensity anticoagulation group with INR≤3,42 cases in high intensity anticoagulation group with INR3）and 264 cases in hypertension related ICH group. The patients in warfarin related ICH group and hypertension related ICH group were compared in respects of sex,age,amount of bleeding,bleeding location and in-hospital mortality. The morbidity,the amount of bleeding and in-hospital mortality were compared between warfarin related ICH low and high intensity anticoagulation groups. RESULTS：The male patients in warfarin related ICH group were less than those of hypertension related ICH group（53.4% vs. 64.7%,P〈0.05）,and the patients in warfarin related ICH group were older than those of hypertension related ICH group [（67.5 ± 19.4） years vs.（61.9±15.8）years,P〈0.05]. The average amount of bleeding in warfarin related ICH group was significantly more than that of hypertension related ICH group [（55±24）ml vs.（26±19）ml,P〈0.05]. The lobar hemorrhage in warfarin related ICH group was more than that of hypertension related ICH group（50.0% vs. 11.7%,P〈0.05）,and basal ganglia hemorrhage was less than that of hypertension related ICH group（25.9% vs. 54.2%,P〈0.05）. The in-hospital mortality in warfarin related ICH group was significantly higher than that of hypertension related ICH group（48.3% vs. 13.6%,P〈0.05）;the morbidity（72.4% vs. 27.6%,P〈0.05）,average amount of bleeding [（59±29）ml vs.（32±13）ml,P〈0.05] and in-hospital mortality（59.5% vs. 18.8%,P〈0.05）in warfarin related ICH high intensity anticoagulation group were significantly increased than those of low intensity anticoagulation g

关 键 词：华法林 高血压 颅内出血 抗凝强度 临床特点 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R973.2[医药卫生—临床医学]