溶栓前血清钙和尿酸水平对急性缺血性脑卒中静脉溶栓后出血转化的预测价值  

Value of serum calcium and UA levels before thrombolysis for predicting HT in AIS patients after intravenous thrombolysis

作　　者：孙若楠 赵源征[1] 朱迎慧[1] 晁志文[1] 刘珊珊[1] 苑和平 杨卓滢 何远宏[1] Sun Ruonan;Zhao Yuanzheng;Zhu Yinghui;Chao Zhiwen;Liu Shanshan;Yuan Heping;Yang Zhuoying;He Yuanhong(Department of Neurology,No.5 Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学第五附属医院神经内一科,450000

出　　处：《中华老年心脑血管病杂志》2021年第6期617-620,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探究溶栓前血清钙、尿酸水平对急性缺血性脑卒中(AIS)患者静脉溶栓后出血转化(HT)的预测价值。方法回顾性收集接受重组组织型纤溶酶原激活剂静脉溶栓治疗的AIS患者228例,分为非HT组198例和HT组30例。分析2组溶栓前血清钙、血尿酸差异。采用多因素logistic回归分析,用ROC曲线评估预测价值。结果HT组溶栓前血清钙、尿酸水平明显低于非HT组(P<0.05,P<0.01)。多因素logistic回归分析显示,溶栓前血清钙、尿酸水平是AIS患者溶栓后HT独立危险因素(P<0.05,P<0.01)。溶栓前血清钙、血尿酸预测AIS患者静脉溶栓后HT的ROC曲线下面积分别为0.726(95%CI:0.664~0.783,P=0.000)、0.680(95%CI:0.615~0.740,P=0.001),2项指标预测效能相似(P=0.528)。结论溶栓前血清钙、尿酸水平对AIS患者静脉溶栓后HT均具有一定的预测价值,可为临床医生初步判断HT风险、制定合理诊疗方案提供依据。Objective To study the value of serum calcium and UA levels before thrombolysis for predicting hemorrhagic transformation(HT)in AIS patients after intravenous thrombolysis.Methods Two hundred and twenty-eight AIS patients who underwent intravenous rt-PA thrombolysis within 4.5 h after onset of AIS were divided into HT-free group(n=198)and HT group(n=30).Their baseline characteristics,serum calcium and UA level were analyzed.The independent risk factors for HT in AIS patients after intravenous thrombolysis were analyzed by multivariate logistic regression analysis.The value of serum calcium and UA levels was assessed by ROC curve analysis.Results The serum calcium and UA levels before thrombolysis were significantly lower in HT group than in HT-free group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that serum calcium and UA levels were the independent factors for HT in AIS patients after thrombolysis.The AUC for serum calcium and uric acid levels in predicting HT in AIS patients after intravenous thrombolysis was 0.726 and 0.680 respectively(95%CI:0.664-0.783,P=0.000;95%CI:0.615-0.740,P=0.001).The efficiency of serum calcium and UA levels was similar in predicting HT in AIS patients after intravenous thrombolysis(P=0.528).Conclusion The serum calcium and UA levels before thrombolysis play a certain role in predicting HT in AIS patients after intravenous thrombolysis and can help the clinicians to preliminarily judge the risk of HT and provide evidence for the clinicians to work out its rational treatment plan.

关 键 词：钙 尿酸 卒中 出血 血小板聚集 

分 类 号：R743.3[医药卫生—神经病学与精神病学]