急性脑梗死患者阿替普酶溶栓出血不良反应及影响因素分析  

Analysis of bleeding induced by alteplase and its influential factors in patients with acute cerebral infarction

作　　者：郭未艳[1] 吕娟 王园姬 李亚美 吴松笛[2] 王芳[2] 蔺雪梅[2] GUO Wei-yan;LV Juan;WANG Yuan-ji;LI Ya-mei;WU Song-di;WANG Fang;LIN Xue-mei(Department of Pharmacy,Xi'an No.1 Hospital,Xi'an 710002,China;Department of Neurology,Xi'an No.1 Hospital,Xi'an 710002,China)

机构地区：[1]西安市第一医院药剂科,陕西西安710002 [2]西安市第一医院神经内科,陕西西安710002

出　　处：《中国药物应用与监测》2020年第4期222-225,共4页Chinese Journal of Drug Application and Monitoring

基　　金：陕西省重点研发计划项目(2015SF228)。

摘　　要：目的:探讨急性脑梗死(ACI)经阿替普酶静脉溶栓治疗后出血不良反应及影响因素。方法:采用回顾性研究方法,记录经阿替普酶静脉溶栓治疗的ACI患者溶栓后是否发生出血不良反应。对比出血患者和未出血患者之间的临床资料,分析出血不良反应的独立危险因素。结果:42例患者溶栓后发生出血,与未出血患者年龄、高血压史、心衰病史、基线血糖差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄(OR=1.034,95%CI:1.000~1.068)、高血压史(OR=2.918,95%CI:1.056~8.062)、基线血糖(OR=1.168,95%CI:1.031~1.324)是发生出血不良反应的独立危险因素(P<0.05)。结论:年龄、高血压史、基线血糖是ACI患者阿替普酶溶栓后出血的独立危险因素,临床医师应加以重视。Objective:To investigate the bleeding events and the relative risk factors in acute cerebral infarction(ACI)patients treated with alteplase for thrombolysis.Methods:Retrospective study method was used to record whether ACI patients developed bleeding events after being treated with alteplase for thrombolysis.Clinical data of the patients with or without bleeding events were compared and the independent risk factors of bleeding induced by alteplase were clarified.Results:There were 42 patients developed bleeding events after using alteplase for thrombolysis.And there were significant differences in age,history of hypertension,heart failure,and the baseline of blood glucose between patients with and without bleeding events(P<0.05).Results of multivariate Logistic regression analysis showed that the age(OR=1.034,95%CI:1.000-1.068),hypertension history(OR=2.918,95%CI:1.056-8.062),and baseline of blood glucose(OR=1.168,95%CI:1.031-1.324)were independent risk factors for bleeding induced by alteplase(P<0.05).Conclusion:Age,hypertension history and baseline of blood glucose were independent risk factors of bleeding induced by alteplase in ACI patients,which should be paid more attentions to in clinic.

关 键 词：急性脑梗死 阿替普酶 静脉溶栓 出血不良反应 

分 类 号：R969.4[医药卫生—药理学] R972.6[医药卫生—药学]