脑梗死出血性转化相关危险因素分析

Risk factors of hemorrhagic transformation after cerebral infarction

目的 探讨脑梗死出血性转化的相关危险因素.方法 回顾性分析2005年1月至2010年1月收治的100例脑梗死出血性转化患者及性别、年龄相匹配的100例脑梗死非出血性转化患者的临床及神经影像学资料,列入以下危险因素行单因素分析：既往高血压病史、糖尿病病史,入院时血压、血糖水平,梗死面积,酗酒,吸烟,心房颤动,高胆固醇血症,抗凝＋抗血小板聚集治疗等,对以上因素行卡方检验或t检验,将可能与脑梗死出血性转化有关的因素采用Logistic回归分析,以筛选出与脑梗死出血性转化相关的危险因素.结果 心房颤动（OR=5.483,95%CI∶2.756～10.253,P=0.000）、大面积脑梗死（OR=5.252,95%CI∶1.308～21.083,P=0.019）、入院时血糖（OR=4.500,95%CI∶1.029～19.684,P=0.046）、入院时血压（OR=2.050,95%CI∶1.019～3.016,P=0.047）、抗凝＋抗血小板聚集治疗（OR=2.353,95%CI∶1.198～4.292,P=0.018）为脑梗死出血性转化的相关危险因素.结论 心房颤动、大面积脑梗死、入院时血糖、入院时血压、抗凝＋抗血小板聚集治疗是脑梗死出血性转化的主要危险因素.同时脑梗死出血性转化的发生是多因素、多机制共同作用的结果.

Objective To investigate the risk factors of hemorrhagic transformation （HT） after cerebral infarction. Methods The clinical and neuroimaging data of 100 patients （gender,age-matched）with cerebral infarction and hemorrhagic transformation from January 2005 to January 2010 were analyzed retrospectively. The following factors were listed for single factor analysis： the history of hypertension, diabetes mellitus,admission blood pressure,blood sugar,infarction size,alcohol,smoking,atrial fibrillation,hypercholesterolemia, combined anticoagulant and antiplatelet aggregation therapy. All the above factors were analyzed by chi-square test or t test, and Logistic regression analysis was used to screen out the related risk factors of HT from the potentially related factors. Results Atrial fibrillation （OR =5.483,95%CI：fibrillation,extensive cerebral infarction,blood sugar,high blood pressure at the beginning of the disease,combined anticoagulant and antiplatelet aggregation therapy are the major risk factors of HT. At the same time, the occurrence of HT is the result of the joint effect of multiple factors and multiple mechanisms.