HAT评分对急性脑梗死患者阿替普酶静脉溶栓后出血转化的预测  

HAT score for predicting hemorrhagic transformation in stroke patients treated with alteplase

作　　者：郭耀强 白宏英[2] 录海斌 刘海涛[1] 司亚克 赵祚翔 GUO Yaoqiang;BAI Hongying;LU Haibin;LIU Haitao;SI Yake;ZHAO Zuoxiang(Zhengzhou People's Hospital,Zhengzhou 450003,China;The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州人民医院,河南郑州450003 [2]郑州大学第二附属医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2020年第23期2092-2096,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关项目(编号:LHGJ20191066)。

摘　　要：目的探讨溶栓后出血评分对急性脑梗死患者接受阿替普酶静脉溶栓后出血转化的预测价值。方法选取郑州人民医院神经内科2019-06—2020-06接受阿替普酶静脉溶栓治疗的急性脑梗死患者148例作为研究对象,对所有患者行HAT评分,以评分结果分组,比较各组患者溶栓后出血转化情况。结果纳入研究的患者中25例发生出血转化,其中6例为脑实质内血肿,7例表现为症状性出血转化,不同分组间出血转化发生率比较有统计学差异(χ^2=22.650,P<0.01),Spearman等级相关分析结果显示HAT评分与溶栓后出血转化间有相关性(r=0.309,P<0.001)。结论对于时间窗内的急性脑梗死患者,HAT评分越高,应用阿替普酶静脉溶栓治疗后出血转化的风险就越高。Objective To evaluate the value of HAT score for predicting hemorrhagic transformation in stroke patients treated with alteplase.Methods A total of 148 stroke patients,treated with alteplase in Neurology Department from June 2019 to June 2020,were selected.All subjects were evaluated by HAT score,and then divided into different groups according to their score.Incidence of hemorrhagic transformation was compared.Results Hemorrhagic transformation happened in 25 patients.seven of them,including 6 parenchymal hematoma patients,suffered from symptomatic intracranial hemorrhage.There was significant difference of hemorrhagic transformation incidence in each group(χ^2=22.650,P<0.01).Spearman correlation analysis showed that HAT score was positively correlated with the incidence of hemorrhagic transformation(r=0.309,P<0.001).Conclusion Stroke patients with higher HAT score has a greater risk of hemorrhagic transformation.HAT score may be useful to predict hemorrhagic transformation risk of stroke patients treated with intravenous Alteplase.

关 键 词：脑梗死 阿替普酶 静脉溶栓 出血转化 溶栓后出血评分 

分 类 号：R743.33[医药卫生—神经病学与精神病学]