非溶栓急性脑梗死患者出血转化相关危险因素的Meta分析  

Meta analysis of risk factors for hemorrhagic transformation in patients with acute cerebral infarction treated with non thrombolytic therapy

作　　者：甄海艳 滕飞月 谢云亮[1] ZHEN Hai-yan;TENG Fei-yue;XIE Yun-liang(Department of Neurology,Affiliated Hospital of Beihua University,Jilin 132000,China)

机构地区：[1]北华大学附属医院神经内科,吉林132000

出　　处：《临床神经病学杂志》2021年第2期100-105,共6页Journal of Clinical Neurology

摘　　要：目的通过Meta分析研究非溶栓急性脑梗死患者出血转化(HT)相关危险因素,为临床上早期识别、预防提供循证医学依据。方法检索PubMed、EMBASE、the Cochrane Library、CNKI、万方、维普、CBM数据库,筛选非溶栓急性脑梗死患者HT相关危险因素的文献,运用Revman 5.3和Stata 14软件对纳入的文献进行Meta分析。结果纳入的16项研究中总样本量7045例,HT组986例,非HT组6059例。Meta分析各危险因素的合并OR值及95%CI分别为:男性0.81(0.68,0.96),年龄0.70(-0.16,1.55),心房颤动3.35(2.25,4.48),高血压0.82(0.67,1.01),糖尿病1.23(0.96,1.52),高脂血症1.24(0.53,2.91),卒中史1.33(0.98,1.79),饮酒史1.30(0.84,1.99),吸烟史1.92(1.19,3.10),抗血小板治疗0.67(0.29,1.56),抗凝治疗2.18(1.15,4.12),大面积梗死4.08(2.40,6.94),血糖1.08(0.67,1.49),收缩压7.07(-3.51,17.55),舒张压0.61(-1.26,2.49),总胆固醇-0.17(-0.31,-0.03),三酰甘油-0.12(-0.21,-0.04),低密度脂蛋白-0.01(-0.21,0.18),高密度脂蛋白0.04(0.01,0.08),血小板计数4.93(-18.44,28.31),NIHSS评分2.94(1.41,4.47)。结论心房颤动、大面积梗死、吸烟、抗凝治疗及NIHSS评分为非溶栓急性脑梗死患者HT的危险因素。男性、高密度脂蛋白、总胆固醇及三酰甘油为非溶栓急性脑梗死患者HT的保护性因素。年龄、高血压、糖尿病、卒中史、高脂血症、低密度脂蛋白、血糖、收缩压、舒张压、饮酒、抗血小板治疗及血小板计数与非溶栓急性脑梗死患者HT无关。Objective To study the risk factors related to hemorrhagic transformation(HT)in patients with acute cerebral infarction after non-thrombolytic therapy by Meta-analysis,and to provide evidence-based medicine basis for early clinical identification and prevention.Methods PubMed,EMBASE,the Cochrane Library,CNKI,WANFANG,VIP and CBM databases were searched to find out and screen the related risk factors of HT in patients with acute cerebral infarction after non-thrombolytic.Then Revman 5.3 and stata14 software were used for meta-analysis.Results The total sample size of 16 included studies was 7045 cases,including 986 cases in HT group and 6059 cases in non-HT group.The OR and 95%CI of all risk factors in meta-analysis were respectively:male 0.81(0.68,0.96),age 0.70(-0.16,1.55),atrial fibrillation 3.35(2.25,4.48),hypertension 0.82(0.67,1.01),diabetes 1.23(0.96,1.52),hyperlipidemia 1.24(0.53,2.91),stroke history 1.33(0.98,1.79),drinking history 1.30(0.84,1.99),smoking history 1.92(1.19,3.10),antiplatelet therapy 0.67(0.29,1.56),anticoagulant therapy 2.18(1.15,4.12),massive infarction 4.08(2.40,6.94),blood glucose 1.08(0.67,1.49),systolic blood pressure 7.07(-3.51,17.55),diastolic blood pressure 0.61(-1.26,2.49),total cholesterol-0.17(-0.31,-0.03),triglyceride-0.12(-0.21,-0.04),low density lipoprotein-0.01(-0.21,0.18),high density lipoprotein 0.04(0.01,0.08),platelet count 4.93(-18.44,28.31),NIHSS score 2.94(1.41,4.47).Conclusions Atrial fibrillation,massive infarction,smoking,anticoagulation therapy and NIHSS scores are risk factors for HT in patients with acute cerebral infarction after non-thrombolytic therapy.Male,high density lipoprotein,total cholesterol and triglyceride are the protective factors of HT in patients with acute cerebral infarction after non-thrombolytic therapy.Age,hypertension,diabetes,stroke history,hyperlipidemia,low density lipoprotein,blood glucose,systolic blood pressure,diastolic blood pressure,drinking history,antiplatelet therapy and platelet count are not related to the HT of patients with

关 键 词：非溶栓 脑梗死 出血转化 危险因素 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]