急性脑梗死患者自发性出血性转化的危险因素分析  

Analysis on risk factors for spontaneous hemorrhagic transformation after acute cerebral infarction

作　　者：石福宏[1] 吴庆周[1] 吕秋杰[1] 井晶[1] 

机构地区：[1]河南省安阳市第三人民医院神经内科,河南安阳455000

出　　处：《临床和实验医学杂志》2015年第24期2034-2037,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨急性大面积脑梗死患者自发性出血性转化的危险因素。方法急性大面积脑梗死患者112例,将患者按照是否发生出血性转化分为观察组和对照组。比较两组患者的一般资料、既往疾病史、实验室检查及体检和治疗方式等,并对脑梗死患者发生自发性出血性转化的可能危险因素进行Logistic回归分析。结果急性大面积脑梗死患者出血性转化发生率为25.00%。观察组有饮酒史及吸烟史的患者比率低于对照组,差异具有统计学意义(P<0.05),其余各项一般资料无显著差异(P>0.05)。观察组患者纤维蛋白原、低密度脂蛋白胆固醇(LDL-C)及总胆固醇(TC)明显低于对照组,而脂蛋白a(LPa)、脉压明显高于对照组,差异有统计学意义(P<0.05)。Logistic回归分析表明,脉压、纤维蛋白原、LDL-C、TC、LPa是急性大面积脑梗死患者发生自发性出血性转化的独立危险因素(OR=1.81、2.40、2.35、2.33、2.77,P<0.05)。结论脉压、LDL-C、TC、LPa、低纤维蛋白原是急性大面积脑梗死后自发性出血性转化的独立危险因素。Objective To explore the risk factors for spontaneous hemorrhagic transformation in patients with acute massive cerebral infarction. Methods The clinical data of 112 patients with acute massive cerebral infarction were retrospectively analyzed ands compared. They were divided into observation group and control group according to whether they had hemorrhagic transformation or not. The general information of patients in these two groups had been compared,and the possible risk factors for spontaneous hemorrhagic transformation were identified by multivariate logistic regression analysis. Results The incidence of hemorrhagic transformation in patients with acute massive cerebral infarction was25%. There was significant difference in the history of smoking and drinking between these two groups（ P 〈 0. 05）,and the difference in other general information was not significant（ P 〉 0. 05）. The blood levels of fibrinogen,LDL- C and TC in patients of observation group were significantly lower than those of patients in control group,while Lpa and pulse pressure were significantly higher than those of patients in control group（P 〈 0. 05）. Logistic regression analysis showed that pulse pressure,Lpa and blood levels of fibrinogen,TC and LDL- C were independent risk factors for the occurrence of spontaneous hemorrhagic transformation in patients with acute massive cerebral infarction（ OR = 1. 81,2. 40,2. 35,2. 33,2. 77,P 〈 0. 05）. Conclusion Pulse pressure,LDL- C,TC,Lpa and low fibrinogen level are independent risk factors for spontaneous hemorrhagic transformation after cerebral infarction.

关 键 词：急性脑梗死 出血性转化 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]