脑梗死自发性出血性转化的影响因素分析

Analysis of factors influencing hemorrhagic transformation of cerebral infarction

目的:探索脑梗死患者发生自发性出血性转化的影响因素。方法:回顾分析了2013—2015年南方医科大学附属南海医院发生出血性转化的脑梗死患者68例,抽取同时期81例未发生出血性转化的脑梗死患者作为对照组。比较2组患者性别、年龄、高血压病史、糖尿病病史、既往卒中病史、心房颤动(房颤)病史、血糖水平、血脂水平、凝血功能、血小板计数、抗凝及抗血小板药物使用、梗死面积的差异,并采用单因素及Logistic回归分析上述因素与脑梗死自发性出血性转化的相关性。结果:2组患者年龄、高血压病史、活化部分凝血活酶时间(APTT)、大面积脑梗死差异有统计学意义(均P<0.05),Logistic回归分析显示APTT及大面积脑梗死是脑梗死患者发生出血性转化的危险因素。结论:APTT延长及大面积脑梗死的患者容易发生出血性转化。

Objective To explore the influencing factors of hemorrhagic transformation of cerebral infarction. Methods A retrospective analysis of 149 patients with cerebral infarction was performed. Patients with hemorrhagic transformation were categorized as the observation group （n=68） and patients without hemorrhagic transformation were served as the control group （n=81）. Compare the differences of the factors including sex, age, atrial fibrillation, hypertension, diabetes, previous stroke, blood glucose level, cholesterol level, number of blood platelet, blood coagulation function, use of anticoagulant and antiplatelet drugs, and size of infarct between the two groups. Single variant analysis and Logistic regression analysis were performed to identify the factors significantly associated with hemorrhagic transformation of cerebral infarction. Results Age, hypertension, activated partial thromboplastin time（APTF） and large size infarct were different significantly be- tween the two groups （all P〈0.05）, and Logistic regression analysis revealed that AprIT and large size infarct were indepen- dent risk factors of hemorrhagic transformation. Conclusions Patients with long APTT and large size infarct may have higher risk of hemorrhagic transformation.