非静脉溶栓急性脑梗死患者取栓治疗后出血转化的相关因素分析  

Factors related to hemorrhagic transformation after thrombectomy in acute cerebral infraction patients without intravenous thrombolysis

作　　者：魏超 徐姣娜 陈天文 孟钰婷 牛国忠[2] WEI Chao;XU Jiaona;CHEN Tianwen;MENG Yuting;NIU Guozhong(The Fourth Clinical Medical College,Chinese Medicine University,Hangzhou 310053,China)

机构地区：[1]浙江中医药大学第四临床医学院,杭州310053 [2]浙江大学医学院附属杭州市第一人民医院神经内科

出　　处：《浙江医学》2020年第22期2429-2432,共4页Zhejiang Medical Journal

摘　　要：目的探讨非静脉溶栓急性脑梗死患者血管内取栓治疗后发生出血转化的相关因素。方法选取2018年1月至2019年3月在浙江大学医学院附属杭州市第一人民医院行血管内取栓治疗的非静脉溶栓急性脑梗死患者103例,根据术后有无出血转化分为出血组20例和未出血组83例。分析非静脉溶栓急性脑梗死患者血管内取栓治疗后发生出血转化的相关因素。结果单因素分析显示两组患者尿路感染发生率、尿酸(UA)比较差异均有统计学意义(均P<0.05)。ROC曲线显示UA预测非静脉溶栓急性脑梗死患者取栓治疗后出血转化的AUC为0.724(95%CI:0.064~0.844),确定UA最佳截点值为372μmol/L。多因素logistic回归显示UA≥372μmol/L是非静脉溶栓急性脑梗死患者取栓治疗后发生出血转化的的保护因素(OR=0.156,95%CI:0.050~0.486,P=0.001)。结论高水平UA可降低非静脉溶栓脑梗死取栓治疗后发生出血转化的风险。Objective To analysis the factors related to hemorrhagic transformation after endovascular thrombectomy in acute cerebral infraction patients without intravenous thrombolysis.Methods Clinical data of 103 patients with acute cerebral infarction who received endovascular thrombectomy in Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine from January 2018 to March 2019 were retrospectively analyzed.The hemorrhagic transformation after endovascular thrombectomy occurred in 20 cases(hemorrhage group)and did not occurred in 83 cases(non-hemorrhage group).The risk factors endovascular thrombectomy were analyzed.Results There were significant differences in uric acid(UA)and urinary tract infection between two groups(both P<0.05).Receiver operating characteristic curve(ROC)showed that the area under the curve(AUC)of UA in prediction of hemorrhagic transformation was 0.724(95%CI:0.064-0.844)and the optimal cut-off value was 372μmol/L.logistic regression analysis showed that UA≥372μmol/L was a protective factor for hemorrhagic transformation in patients(OR=0.156,95%CI:0.050-0.486,P=0.001).Conclusion High levels of UA may decrease the risk of hemorrhagic transformation after endovascular thrombectomy in acute cerebral infraction patients without intravenous thrombolysis.

关 键 词：急性脑梗死 取栓 出血转化 

分 类 号：R743.33[医药卫生—神经病学与精神病学]