脑梗死出血转化预后的危险因素与抗栓药物继续使用的可行性分析  

Risk Factors for Prognosis of Cerebral Infarction Hemorrhage Transformation and Feasibility Analysis of Continued Use of Antithrombotic Drugs

作　　者：陈丽花 刘秀荣 蒋婧秋 CHEN Lihua;LIU Xiurong;JIANG Jingqiu(Pharmacy Department,Xiamen International Trade Taihe Rehabilitation Hospital,Xiamen 361006,Fujian,China)

机构地区：[1]厦门国贸泰和康复医院药剂科,福建厦门361006

出　　处：《中外医疗》2024年第21期41-45,共5页China & Foreign Medical Treatment

摘　　要：目的分析脑梗死出血转化预后的危险因素与抗栓药物继续使用的可行性。方法回顾性选取2023年1—12月厦门国贸泰和康复医院神经内科收治的40例脑梗死患者的临床资料,根据入院后72 h影像学复诊结果,将患者划分为非出血转化组(n=11)、出血转化组(n=29)。分析引发急性脑梗死出血转化的危险因素以及抗栓药物继续使用的可行性。结果出血转化组患者的平均发病至入院时间、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、脑梗死面积、入院24 h内的血压指标均优于非出血转化组,差异有统计学意义(P均<0.05)。且出血转化组皮质梗死、合并糖尿病史、存在心房颤动、使用抗凝药和溶栓药占比均高于非出血转化组,差异有统计学意义(P均<0.05)。基于多因素Logistic回归分析,急性脑梗死患者的脑梗死面积(OR=2.456,95%CI:2.147~4.332)、NIHSS评分(OR=1.512,95%CI:1.072~1.983)、发生心房颤动(OR=2.557,95%CI:1.337~3.567)、使用抗栓药物(OR=3.471,95%CI:1.332~5.102)和抗凝药物(OR=3.479,95%CI:1.301~4.556)是引发出血转化的独立危险因素(P均<0.05)。两组患者抗栓药物继续使用的预后对比,差异无统计学意义(P>0.05)。结论对于急性脑梗死患者而言,脑梗死面积、NIHSS评分、发生心房颤动、使用抗栓药物和抗凝药物是引发出血转化的独立危险因素,尤其是发病前后的抗栓药物、抗凝药物的使用会直接影响患者的出血转化。Objective To analyze the risk factors of prognosis of cerebral infarction hemorrhage transformation and the feasibility of continued use of antithrombotic drugs.Methods Clinical data of 40 patients with cerebral infarction admitted to the Department of Neurology of Xiamen International Trade Taihe Rehabilitation Hospital from January to December 2023 were retrospectively selected,and the patients were divided into non-hemorrhage conversion group(n=11)and hemorrhage conversion group(n=29)according to the results of imaging revisits 72 h after admission.To analyze the risk factors of bleeding transformation in acute cerebral infarction and the feasibility of continued use of antithrombotic drugs.Results The mean time from onset to admission,the National Institute of Health Stroke Scale(NIHSS)score,the area of cerebral infarction,and the blood pressure index within 24 h after admission in the hemorrhage conversion group were all better than those in the non-hemorrhage conversion group and the differences were statistically significant(all P<0.05).The proportion of cortical infarction,history of diabetes mellitus,atrial fibrillation,anticoagulant and thrombolytic drugs in hemorrhage conversion group was significantly higher than that in non-hemorrhage conversion group,the differences were statistically significant(all P<0.05).Based on multivariate Logistic regression analysis,patients with acute cerebral infarction had cerebral infarction size(OR=2.456,95%CI:2.147-4.332),NIHSS score(OR=1.512,95%CI:1.072-1.983),occurrence of atrial fibrillation(OR=2.557,95%CI:1.337-3.567),use of antithrombotic drugs(OR=3.471,95%CI:1.332-5.102)and anticoagulant drugs(OR=3.479,95%CI:1.301-4.556)and they were independent risk factors for bleeding transformation(all P<0.05).There was no significant difference in the prognosis of continued use of antithrombotic drugs between the two groups(P>0.05).Conclusion For patients with acute cerebral infarction,cerebral infarction size,NIHSS score,occurrence of atrial fibrillation,use of antithrombo

关 键 词：脑梗死 出血转化 预后危险因素 可行性分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]