脑梗死患者溶栓后出血转化的影响因素分析

Influential factors analysis of hemorrhagic transformation after thrombolysis in patients with acute cerebral infarction

目的探讨脑梗死患者溶栓后出血转化的影响因素,为其临床研究提供依据。方法选取100例脑梗死行尿激酶溶栓治疗的患者作为观察对象,根据溶栓后是否发生出血转化分为出血组与未出血组,记录患者溶栓前是否服用抗血小板聚集药物及其他相关信息,筛选出影响出血发生的相关因素,应用Logistic回归分析进行多因素回归分析。结果 100例患者中17例发生出血,占17.0%,其中HI型10例(10.0%),PH型7例(7.0%);17例出血患者中12例(70.6%)服用抗血小板药物。83例未出血患者中仅5例(6.0%)服用抗血小板药物,差异有统计学意义(P<0.05)。年龄、心房颤动、入院NIHSS评分、抗血小板聚集治疗及入院收缩压与溶栓后出血转化发生存在相关性,差异有统计学意义(P<0.05)。Logistics回归分析显示,年龄大、既往心房颤动、抗血小板聚集治疗、入院收缩压高是溶栓后出血转化发生的危险因素(P<0.05)。结论年龄大、既往心房颤动,抗血小板聚集治疗、入院收缩压高可以增加脑梗死患者溶栓后出血转化的发生风险。

Objective To investigate the influential factors of hemorrhagic transformation after thrombolysis in patients with acute cerebral infarction. Methods A total of 100 patients with cerebral infarction after intravenous thrombolysis with urokinase were included. All patients were divided into bleeding group and non-bleeding group according based on whether they had spontaneous bleeding. The relevant factors affecting spontaneous hemorrhagic transformation occurred were selected, and logistic regression analysis was used to analyze multiple factors. Results There were 17 patients （17.0%） with hemorrhage. There were 12 （70.6%） in 17 patients with antiplatelet drugs. There were 5 （6.0%） in 83 patients without usage of antiplatelet drugs. The difference was statistically significant （P 〈 0.05）. There were correlations between hemorrhagic transformation after intravenous thrombolysis and age, atrial fibrillation, NIHSS score, antiplatelet therapy history and hospital admission systolic blood pressure. The differences were statistically significant （P 〈 0.05）. Logistics regression analysis showed that elder, atrial fibrillation, antiplatelet therapy history and hospital admission systolic blood pressure were risk factors for hemorrhagic transformation after intravenous thrombolysis （P 〈 0.05）. Conclusions Elder, atrial fibrillation, antiplatelet therapy history and hospital admission systolic blood pressure may be the influence factors of hemorrhagic transformation after intravenous thrombolysis.