rt-PA治疗醒后缺血性卒中出血转化的危险因素分析  

Analysis of risk factors for hemorrhagic transformation of ischemic stroke after rt-PA treatment

作　　者：陈雅芳[1] 张金英[1] 卓识途 CHEN Yafang;ZHANG Jinying;ZHUO Shitu(Department of Neurology,the Second Affiliated Hospital of Fujian Medical University,Quanzhou,Fujian 362000,China)

机构地区：[1]福建医科大学附属第二医院神经内科,福建泉州362000

出　　处：《现代医药卫生》2022年第11期1825-1827,1833,共4页Journal of Modern Medicine & Health

基　　金：福建省卫生健康科技计划项目(2019-1-53);福建省泉州市科技计划资助项目(2019N084S)。

摘　　要：目的研究重组组织型纤溶酶原激活剂(rt-PA)治疗醒后缺血性卒中出血转化的危险因素。方法选取2019年2月至2021年12月该院收治的醒后缺血性卒中患者36例作为研究对象。患者均应用多模式核磁共振成像(MRI)指导rt-PA治疗。根据是否并发出血转化,将患者分为出血组与非出血组,通过单因素和多因素分析对比2组间的临床资料。结果36例患者中,出血转化3例,无出血转化33例。单因素分析结果显示,2组在性别、高血压、糖尿病、心房颤动(房颤)、溶栓前美国国立卫生研究院卒中量表(NIHSS)评分方面比较,差异均无统计学意义(P>0.05);2组在年龄方面比较差异有统计学意义(P=0.001)。logistic回归分析显示,年龄为出血转化的独立危险因素(比值比=1.23,95%置信区间为0.169~8.960,P=0.04)。结论年龄是rt-PA治疗醒后缺血性卒中出血转化的危险因素。Objective To investigate the risk factors of hemorrhagic transformation in ischemic stroke after waking up with recombinant tissue plasminogen activator(rt-PA).Methods Thirty-six patients with ischemic stroke after waking up admitted to our hospital from February 2019 to December 2021 were selected as the research subjects.All patients were given rt-PA therapy guided by multimodal magnetic resonance imaging(MRI).The patients were divided into hemorrhagic group and non-hemorrhagic group according to whether hemorrhagic transformation was complicated.The clinical data between the two groups were compared by univariate and multivariate analysis.Results Among the 36 patients,3 had hemorrhagic transformation and 33 had no hemorrhagic transformation.Univariate analysis showed that there was no significant difference between the two groups in gender,hypertension,diabetes,atrial fibrillation,and National Institutes of Health Stroke Scale(NIHSS)score before thrombolysis(P>0.05).There was a statistically significant difference in age between the two groups(P=0.001).Logistic regression analysis showed that age was an independent risk factor for hemorrhagic transformation(odds ratio=1.23,95%confidence interval was 0.169-8.960,P=0.04).Conclusion Age is a risk factor for hemorrhagic transformation in ischemic stroke after rt-PA therapy.

关 键 词：年龄 重组组织型纤溶酶原激活剂 醒后缺血性卒中 出血转化 因素 

分 类 号：R743[医药卫生—神经病学与精神病学]