大血管闭塞性脑梗死患者桥接治疗转化性出血的危险因素  

Risk factors of hemorrhagic transformation in bridging therapy for large vessel occlusive cerebral infarction

作　　者：陈坤成[1] 占凌辉[1] 谢芳[1] 陈星宇[1] CHEN Kuncheng;ZHAN Linghui;XIE Fang;CHEN Xingyu(Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院,福建厦门361004

出　　处：《中国实用神经疾病杂志》2022年第6期759-762,共4页Chinese Journal of Practical Nervous Diseases

基　　金：厦门市科技计划项目(编号:3502Z20209036)。

摘　　要：目的分析桥接治疗大血管闭塞性脑梗死出血性转化的危险因素。方法回顾性分析2018-01—2020-12厦门大学附属中山医院收治的73例接受桥接治疗大血管闭塞性脑梗死患者的临床资料,根据治疗后患者是否出现转化性出血分为出血性组(21例)和非出血性组(52例)。比较2组患者性别、年龄、是否吸烟、是否合并高血压、是否合并糖尿病、是否合并房颤、是否合并高脂血症、血小板相关数值、肝肾功能、凝血功能、NIHSS评分等指标,采取多因素Logistic回归分析大血管闭塞性脑梗死出血性转化的危险因素。结果出血组患者年龄>70岁(P=0.027)、血小板计数<185×10^(9)个/L(P=0.029)、APTT>30.3 s(P=0.014)、NIHSS评分>18分(P=0.015)是大血管闭塞性脑梗死转化性出血的危险因素。结论年龄大、血小板计数低、APTT时间延长、NIHSS评分均可能会影响大血管闭塞性脑梗死的疗效,增加术后转化性出血的发生率,是大血管闭塞性脑梗死患者转化性出血的危险因素,应引起临床重视。Objective To analyze the risk factors of hemorrhagic transformation in bridging therapy for large vessel occlusive cerebral infarction.Methods The clinical data of 73 patients with large vessel occlusive cerebral infarction who received bridging therapy from January 2018 to December 2020 in Zhongshan Hospital Af⁃filiated to Xiamen University were retrospectively analyzed.According to the number of cases,they were divided into hemorrhagic group(21 cases)and non-hemorrhagic group(52 cases).Gender,age,smoking,hypertension,diabetes,atrial fibrillation,hyperlipidemia,platelet-related values,liver and kidney function,blood coagulation function,and baseline National Institutes of Health stroke scale(NIHSS)were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the risk factors of hemorrhagic transformation of large ves⁃sel occlusive cerebral infarction.Results Age>70 years,blood platelet<185×10^(9) L^(-)1,APTT>30.3 s,and NIHSS score>18 in the hemorrhagic group were risk factors for hemorrhagic transformation of large vessel occlusive cere⁃bral infarction(P<0.05).Conclusion Older age,low blood platelet,prolonged APTT time,and NIHSS score may affect the curative effect of large vessel occlusive cerebral infarction,increase the incidence of postoperative hemorrhagic transformation,and are the risk of hemorrhagic transformation in patients with large vessel occlusive cerebral infarction.Factors risk factors for hemorrhagic transformation should be paid attention to by clinicians.

关 键 词：脑梗死 桥接治疗 大血管闭塞性 转化性出血 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]