急性脑梗死后非溶栓患者出血转化的影响因素分析

Influencing factors of hemorrhagic transformation in patients with acute cerebral infarction after non receiving thrombolysis agent

目的研究急性脑梗死后非溶栓患者出血转化的影响因素。方法选取2014年2月至2015年8月,在首都医科大学附属北京朝阳医院神经内科进行住院治疗的急性脑梗死后非溶栓患者196例,按照患者是否发生出血转化分为出血转化组（54例）,未出血转化组（142例）。收集统计以上患者相关资料信息,所有指标进行单因素分析,将其中对比结果差异有统计学意义的危险因素进行多因素Logistic回归分析。结果两组患者心房颤动、吸烟史以及饮酒史对比差异有统计学意义（P〈0.05）;两组患者入院空腹血糖以及低密度脂蛋白胆固醇（low density lipoprotein-cholesterol,LDL-C）浓度比较,差异具有统计学意义（P〈0.05）;两组患者梗死面积情况对比差异具有统计学意义（P〈0.05）。经多因素Logistic回归分析,影响急性脑梗死患者出血转化的独立因素分别为心房颤动（OR=4.528,95%CI：2.035~9.283,P=0.000）、入院时血糖浓度（OR=1.083,95%CI：1.040~2.243,P=0.000）、LDL-C（OR=2.574,95%CI：1.258~5.279,P=0.000）以及梗死面积（OR=2.728,95%CI：1.382~6.907,P=0.000）。结论心房颤动、入院时血糖浓度高、LDL-C以及大面积梗死属于急性脑梗死后非溶栓患者出血转化的危险因素。

Objective To study the influencing factors of hemorrhagic transformation in patients with acute cerebral infarction after non thrombolytic therapy. Methods From February 2014 to August 2015,196 cases of patients with acute cerebral infarction who were admitted to our hospital were treated with acute cerebral infarction. According to the occurrence of bleeding in patients with bleeding into the transformation group（ 54 cases）,no bleeding transformation group（ 142 cases）. Statistical data were collected and all indexes were analyzed by single factor. The risk factors of P〈0. 05 were analyzed by multi factor Logistic regression analysis. Results The two groups of atrial fibrillation,smoking history and drinking history were significantly different,with statistical significance（ P〈0. 05）. Two groups of hospital admission fasting blood glucose and low density lipoprotein-cholesterol（ LDL-C） levels were significantly different,with statistical significance（ P〈0. 05）. Two groups of infarct size were significantly different,with statistical significance（ P〈0. 05）. By multivariate Logistic regression analysis,the independent factors that influence the hemorrhage transformation in patients with acute cerebral infarction were atrial fibrillation（ OR = 4. 528,95% CI： 2. 035-9. 283,P = 0. 000）,admission blood glucose（ OR = 1. 083,95% CI：1. 040-2. 243,P = 0. 000）,LDL-C（ OR = 2. 574,95% CI： 1. 258-5. 279,P = 0. 000） and large area of infarction（ OR = 2. 728,95% CI：1. 382-6. 907,P = 0. 000）. Conclusion Atrial fibrillation,blood glucose,LDL-C and large area of infarction in patients with acute cerebral infarction are the risk factors of hemorrhagic transformation after acute cerebral infarction.