急性缺血性脑卒中静脉溶栓出血性转化风险预测的研究进展  

Research progress on risk prediction of hemorrhagic transformation in acute ischemic stroke after intravenous thrombolysis

作　　者：李欣明 蔡文强 谭衍 陆弘盈[1] 边远[1] 宋进赵 LI Xinming;CAI Wenqiang;TAN Yan;LU Hongying;BIAN Yuan;SONG Jinzhao(Center of Cerebrovascular Disease,Guigang People's Hospital,Guangxi Zhuang Autonomous Region,Guigang537100,China)

机构地区：[1]广西壮族自治区贵港市人民医院脑血管病中心,广西贵港537100

出　　处：《中国当代医药》2023年第10期64-68,共5页China Modern Medicine

摘　　要：脑卒中在临床上属于脑血管疾病中的常见病,当前约有90%的脑卒中为缺血性脑卒中。随着人口老龄化的发展,脑卒中的发病率也呈逐年上升趋势。目前,临床上治疗急性缺血性脑卒中的方法主要为静脉溶栓,而静脉溶栓治疗对患者神经功能缺损状态有积极的改善作用,且可以在一定程度上预防患者出现残疾、死亡等严重后果,提升患者的生存质量,增强其日常活动能力。但我国当前的溶栓率极低,患者及家属不接受静脉溶栓的主要原因之一是担心静脉溶栓后出血性转化(HT)的发生。出血性转化一旦发生,可能会导致患者病情迅速恶化,甚至死亡,故急性缺血性脑卒中早期积极行静脉溶栓的同时,应重点关注HT风险。为了提升静脉溶栓治疗的安全性,还要明确引发HT的危险因素,并针对导致患者HT的危险因素,采取相应的HT预防措施和改善患者转归的方法,保障急性缺血性卒中患者静脉溶栓治疗的安全性。Acute ischemic stroke is a high incidence disease type in cerebrovascular diseases,and about 90%of stroke patients are ischemic stroke.With the development of population aging,the incidence rate of stroke is also increasing year by year.At present,intravenous thrombolysis is the main clinical treatment for acute ischemic stroke,which has a positive effect on improving the neurological deficit of patients,and can prevent serious consequences such as disability and death of patients to a certain extent,improve the quality of life of patients and enhance their daily activities.However,the current thrombolytic rate in China is extremely low.One of the main reasons why patients and their families do not accept intravenous thrombolysis is that they are worried about the occurrence of hemorrhagic transformation(HT)after intravenous thrombolysis.Once hemorrhagic transformation occurs,it may lead to rapid deterioration of the patients'condition and even death.Therefore,when intravenous thrombolysis is actively performed in the early stage of acute ischemic stroke,attention should be paid to the risk of HT.In order to improve the safety of intravenous thrombolytic therapy,it is necessary to clarify the risk factors of HT,and take corresponding HT prevention measures and improve the outcome of patients according to the risk factors of HT,so as to ensure the safety of intravenous thrombolytic therapy in patients with acute ischemic stroke.

关 键 词：CT灌注成像 MR灌注成像 出血性转化 急性缺血性脑卒中 核心梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]