缺血性脑卒中患者静脉溶栓后颅内出血转化的影响因素分析  

Analysis on the factors influencing intracranial haemorrhage in ischemic stroke patients

作　　者：石红婷[1] 刁芳明[1] 董亚贤[1] 钟高贤[1] 尧慧燕 陈霄莲[1] SHI Hong-ting;DIA0 Fang-ming;D0NG Ya-xian(Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China)

机构地区：[1]广州医科大学附属第二医院神经内科,广东广州511447

出　　处：《吉林医学》2018年第12期2231-2234,共4页Jilin Medical Journal

摘　　要：目的:探讨缺血性脑卒中患者静脉溶栓后颅内出血转化的影响因素。方法:选择发病在4. 5 h内的急性缺血性脑卒中患者125例,先采用阿替普酶静脉溶栓,然后应用CT或MRI扫描仪判断出颅内出血组与非颅内出血组,并采用Logistic回归分析颅内出血转化的影响因素。结果:125例缺血性脑卒中患者中颅内出血者23例(18. 40%),非颅内出血者102例(81. 60%)。年龄(OR=2. 50,95%CI 1. 93～8. 46,P=0. 01)、基线血糖浓度(OR=4. 53,95%CI2. 06～15. 69,P=0. 00)、基线NIHSS评分(OR=3. 62,95%CI 1. 81～11. 25,P=0. 00)、发病至溶栓时间(OR=2. 67,95%CI 1. 94～10. 88,P=0. 01)、心房颤动(OR=1. 35,95%CI 1. 56～1. 01,P=0. 03)为发生颅内出血的独立危险因素。两组在90d良好预后方面比较,差异有显著统计学意义(P <0. 05)。结论:缺血性脑卒中患者静脉溶栓后颅内出血严重影响患者近期预后,颅内出血与年龄、基线血糖浓度、基线NIHSS评分、发病至溶栓时间、心房颤动有关。Objective To investigate the influential factors of intracranial haemorrhage in patients with ischemic stroke. Method 125 patients with ischemic stroke were enrolled at 0-4. 5 h after onset. They were given intravenous thrombolysis by alteplase. The patients who applyed CT or MRI scanner to judge the intracranial haemorrhage( ICH) group and non-intracranial haemorrhage( NICH) group. Logistic regression model was used to estimate the risk factors of intracranial haemorrhage. Results Of 125 patients,23( 18. 40%) patients were intracranial haemorrhage and 102( 81. 60%) patients were non-intracranial haemorrhage. age( OR = 2. 50,95% CI 1. 93 ~ 8. 46,P = 0. 01) 、baseline blood glucose( OR = 4. 53,95% CI 2. 06 ~15. 69,P = 0. 00) 、baseline NIHSS score( OR = 3. 62,95% CI 1. 81 ~ 11. 25,P = 0. 00) 、thrombolysis time( OR = 2. 67,95% CI1. 94 ~ 10. 88,P = 0. 01) 、atrial fibrillation( OR = 1. 35,95% CI 1. 56 ~ 1. 01,P = 0. 03) were independent risk factors of intracranial haemorrhage. There was significant difference in 90 d good prognosis between the two groups. Conclusion Intractranial hemorrhage after intravenous thrombolysis in patients with ischemic stroke severely affects the short-term prognosis of patients,Intracranial haemorrhage is closely correlated with age,baseline blood glucose、baseline NIHSS score,time from onset to thrombolysis and atrial fibrillation.

关 键 词：缺血性脑卒中 颅内出血 静脉溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]