非溶栓治疗后急性脑梗死患者发生出血性转化及转归的影响因素  

Influential Factors of Hemorrhagic Transformation and Outcome in Patients with Acute Cerebral Infarction after Non-thrombolytic Therapy

作　　者：李文玉 LI Wen-yu(Department of Neurology,Pizhou People's Hospital,Pizhou,Jiangsu Province,221300 China)

机构地区：[1]邳州市人民医院神经内三科,江苏邳州221300

出　　处：《中外医疗》2020年第12期49-51,共3页China & Foreign Medical Treatment

摘　　要：目的探讨非溶栓治疗后急性脑梗死患者发生出血性转化及转归的影响因素。方法2017年12月-2019年6月回顾性分析68例急性脑梗死患者临床资料,按是否发生出血性转化分为出血转化组(n=30)及非出血转化组(n=38),探讨两组患者基线资料、脂代谢指标、基础病史等,多因素Logistic回归分析资料。结果出血转化组心房颤动史、吸烟饮酒史发生率分别为53.33%、80.0%,均高于非出血转化组的7.89%、34.21%,差异有统计学意义(χ^2=15.009,12.385,P=0.000,0.000)。观察组空腹血糖、LDL-C水平高于非出血转化组,抗血小板聚集药物、抗凝药物长期使用率高于对照组(P<0.05),大面积梗死发生率63.33%高于非出血转化组的15.79%,差异有统计学意义(χ^2=14.319,P=0.000)。经多因素Logistic回归分析,心房颤动、大面积脑梗死、空腹血糖、低密度脂蛋白胆固醇及抗凝、抗血小板聚集治疗是影响疾病转归危险因素(P<0.05)。结论急性脑梗死后非溶栓治疗患者易发生出血性转化风险,心房颤动、大面积脑梗死、空腹血糖、低密度脂蛋白胆固醇及抗凝、抗血小板聚集治疗是影响疾病转归危险因素。Objective To investigate the influencing factors of hemorrhagic transformation and outcome in patients with acute cerebral infarction after non-thrombolytic therapy.Methods The clinical data of 68 patients from Dceember 2017 to June 2019 with acute cerebral infarction were analyzed retrospectively.They were divided into hemorrhagic transformation group(n=30)and non-hemorrhagic transformation group(n=38)according to whether hemorrhagic transformation occurred.The baseline data,lipid metabolism indicators,and basis of the two groups were discussed Medical history,etc.,multivariate Logistic regression analysis data.Results The incidences of atrial fibrillation history and smoking and drinking history in the hemorrhagic transformation group were 53.33%and 80.0%,respectively,which were higher than the non-hemorrhagic transformation group of 7.89%and 34.21%,with significance(χ^2=15.009,12.385,P=0.000,0.000).The fasting blood glucose and LDL-C levels in the observation group were higher than those in the non-hemorrhagic transformation group.The long-term use rate of antiplatelet aggregation drugs and anticoagulants was higher than that in the control group,the difference was statistically significant(P<0.05).The incidence of large-area infarction was 63.33%higher than that in the non-hemorrhagic transformation group 15.79%,the difference was statistically significant(χ^2=14.319,P=0.000).Multivariate logistic regression analysis showed that atrial fibrillation,large-scale cerebral infarction,fasting blood glucose,low-density lipoprotein cholesterol,anticoagulation,and anti-platelet aggregation therapy were risk factors affecting disease outcome,the difference was statistically significant(P<0.05).Conclusion Patients with non-thrombolytic therapy after acute cerebral infarction are susceptible to the risk of hemorrhagic transformation.Atrial fibrillation,large-scale cerebral infarction,fasting blood glucose,low-density lipoprotein cholesterol,anticoagulation,and anti-platelet aggregation are risk factors affecting the o

关 键 词：急性脑梗死 非溶栓治疗 出血性转化 转归 影响因素 

分 类 号：R743[医药卫生—神经病学与精神病学]