合并脑微出血的脑梗死患者再发脑出血临床分析

Clinical analysis of recurrent cerebral hemorrhage in patients with cerebral infarction complicated with cerebral hemorrhage

目的：探讨合并脑微出血（CMB）的脑梗死患者再发脑出血的相关因素及预防措施。方法选取急性脑梗死患者124例为研究对象，根据磁共振梯度回波 T2加权成像（GRE-T2＊W1）结果分为两组，合并CMB 者42例为研究组，无 CMB 者82例为对照组，比较两组再发脑出血情况及相关因素。结果研究组CMB 在颅内的分布情况为：分布于基底节／丘脑区23个，占54．7％；皮质-皮质下区12个，占28．5％；幕下区7个，占16．7％。再出血发生情况为：基底节／丘脑区11．3％，发生于皮质-皮质下区7．3％，发生于幕下区位0．8％。研究组再出血发生率40．4％，明显高于对照组的10．9％，差异有统计学意义（χ2＝11．263，P ＜0．05）。结论合并 CMB 的脑梗死患者，为再发脑出血的高危人群。通过 GRE-T2＊W1及时发现 CMB，可有效指导临床医生合理选择治疗方案，降低脑出血的发生率，改善患者预后。

Objective To investigate the related factors and prevention measures of recurrent intracerebral hemorrhage in cerebral infarction patients with cerebral microbleeds.Methods 124 patients with acute cerebral infarction were divided into two groups according to the GRE -T2 ＊ W1 examination,cerebral microbleeds as control group（n =42）,non cerebral microbleeds as observation group（n =82）;The recurrence of cerebrahemorrhage and related factors of the two groups were compared.Results In the control group,the distribution of the CMB in intracranial：thalamus -basal ganglia area was 23,accounting for 54.7%;cortical -subcortical area was 12,accounting for 28.5%,under the curtain area was 7,accounting for 16.7%.The incidence of recurrent intracerebral hemorrhage was 1 1 .3 % ,7.3% and 0.8% respectively .The incidence of recurrent intracerebral hemorrhage in the group with CMB（40.4%）was obviously higher than that of without the CMB group（10.9%）,the difference was statistically significant（χ2 =11.263,P 〈0.05 ）.Conclusion The cerebral infarction patients combined with CMB has high -risk in the aspect of recurrent intracerebral hemorrhage.Through the GRE -T2 ＊ W1 to find CMB,which can guide clinical doctors choose reasonable treatment effectively,and then reduce the occurrence of cerebral hemorrhage and improve the prognosis of patients.