急性脑梗死患者动脉溶栓中静脉充盈早现与脑出血发生的关系研究

Correlation between early venous filling during intra arterial thrombolysis and cerebral hemorrhagic complications in patients with acute cerebral infarction

目的探讨急性脑梗死患者动脉溶栓中静脉充盈早现征象与溶栓并发脑出血的关系。方法纳入急性脑梗死患者145例行动脉溶栓治疗,并同时行脑血管造影,依据造影过程中静脉充盈早现征象的有无分为静脉充盈早现组42例和无静脉充盈早现组103例,比较2组并发脑出血的发生率。再将静脉充盈早现组分为丘脑纹状体静脉充盈亚组18例和脑皮质静脉充盈亚组24例,比较该2个亚组并发脑出血的发生率。结果静脉充盈早现组较无静脉充盈早现组并发脑出血的发生率增高(26.2%vs.1.9%),差异有统计学意义(x^2=18.626,P<0.01);丘脑纹状体静脉充盈亚组并发脑出血的发生率高于脑皮质静脉充盈亚组(44.4%vs.12.5%),差异亦有统计学意义(x^2=3.903,P<0.05)。结论动脉溶栓过程中出现静脉充盈早现征象(尤其是丘脑纹状体静脉)提示溶栓并发脑出血的风险增大。

Objective To investigate the relationship between early venous filling and brain hemorrhage during thrombolysis in patients with thrombolyfic therapy for acute cerebral infarction. Methods One hundred and forty-five cases of patients with acute cerebral infarction who treated with arterial thrombolysis were enrolled, cerebral angiography were performed, on the basis of early venous filling sign, patients were divided into venous filling group with 42 cases and no venous filling group with 103 cases, cerebral hemorrhage rate were compared between the 2 groups. Then the vein filling group was divided into thalamostriate vein filling sub group with 18 cases and cerebral cortical vein filling sub group with 24 patients, cerebral hemorrhage rate was compared between the 2 sub-groups. Results Venous early filling group has higher incidence of cerebral thrombosis than in the no venous filling group （26.2% vs. 1.9% ） , the difference was statistically significant （χ^2 = 18. 626, P 〈 0.01 ） ; thalamostriate vein filling subgroup＇s cerebral hemorrhage incidence was higher than that of cerebral cortical vein filling subgroup （44.4% vs. 12.5% ） , the difference was statistically significant （ χ^2 = 3. 903, P 〈 0.05 ）. Con- clusion Venous filling early signs in arterial thrombolysis process （especially the thalamostriate vein thrombolysis） prompted the risk of cerebral hemorrhage complication.