脑梗死急性期早期抗血小板治疗的效果及其出血转化的影响因素分析

The effect of acute cerebral infarction early antiplatelet therapy and its influencing factors analysis of hemorrhagic transformation

目的探讨脑梗死急性期早期抗血小板治疗效果及出血转化影响因素。方法选取2014年2月至2015年12月期间我院收治脑梗死急性期患者164例随机分为研究组和对照组,对照组采用常规方法治疗,研究组在对照组治疗基础采用阿司匹林联合氯吡格雷早期抗血小板治疗,比较两组患者疗效。将治疗后出血转化患者归为A组,将未发生出血转化患者归为B组,采用单因素和多因素回归分析影响脑梗死急性期出血转化危险因素。结果研究组患者治疗总有效率显著高于对照组[95.12%vs.82.93%,P<0.05]。研究组患者中发生出血转化9例,发生率为10.96%;对照组发生出血转化8例,发生率为9.76%,两组患者出血转化发生率比较无统计学意义(P>0.05)。Logistic回归分析得出,年龄≥60岁、脑栓塞、梗死累及皮层、大面积梗死、合并高血压、合并糖尿病及合并高血脂为影响脑梗死急性期出血转化发生危险因素。结论脑梗死急性期早期短期采用抗血小板治疗可提高患者疗效,并不增加出血转化发生率。影响脑梗死急性期出血转化危险因素较多,包括高龄、脑栓塞、梗死累及皮层、大面积梗死、合并高血压、合并糖尿病及合并高血脂等。

Objective To investigate the therapeutic effect and influencing factors of early acute cerebral infarction antiplatelet hemorrhagic transformation. Methods There were 164 cases of patients with acute cerebral infarction form Feb. 2014 to Dec. 2015 in our hospital. They were randomly divided into study group and control group, adopt the conventional approach for curing the control group, and in addition to the control group, apply early aspirin and clopidogrel antiplateletfor curing the study group, compare the two groups of patients in efficacy. After the conversion treatment of bleeding in patients classified as Group A, hemorrhagic transformation in patients classified as grOup B, using univariate and multivariate regression analysis of the impact of acute cerebral infarction risk fac- tors for hemorrhagic transformation will not occur. Results Acute cerebral infarction early short - term use of anti - platelet therapy can improve patient outcomes, does not increase the incidence of hemorrhagic transformation. Acute hemorrhagic transformation of cer- ebral infarction risk factors are more, including the elderly, cerebral embolism, infarction involving the cortex, a large area of infarc- tion, hypertension, diabetes and high cholesterol and other merger, clinical prevention should be targeted. Conclusion Treatment of patients with total efficiency study group was significantly higher [ 95.12% vs. 82.93%, P 〈 0.05 ]. Study group occurred in patients with hemorrhagic transformation in 9 cases, the rate was 10.96% ; 8 cases of hemorrhagic transformation occurred in the control group, the rate was 9.76%, the two groups of patients the incidence of hemorrhagic transformation no significant difference （P 〉 0.05）. Logistic regression analysis, age ≥60 years, cerebral embolism, infarct involving the cortex, a large area of infarction, hypertension, diabetes and high cholesterol for the combined impact of acute cerebral hemorrhage risk factors of conversion.