急性脑梗死溶栓后脑出血的危险因素Logistic回归分析

Logistics regression analysis of risk factors for cerebral hemorrhage after acute cerebral infarction

目的分析急性脑梗死(ACI)患者溶栓后脑出血的危险因素,探讨相应预防措施。方法以本院收治的182例ACI患者为研究对象,患者入院后均实施溶栓治疗,统计溶栓后脑出血发生率,并对ACI溶栓后脑出血的影响因素进行单、多因素分析和Logistic回归分析,探讨合理预防措施。结果本研究182例溶栓后,共62例出现脑出血,发生率为34.07%。单因素分析结果提示,出血组年龄、治疗前NIHSS评分、房颤及心源性脑栓死构成比均较未出血组明显高,发病至静脉溶栓治疗时间较未出血组明显长(P<0.05);Logistic回归分析结果提示,治疗前NIHSS评分过高和合并房颤为ACI溶栓后脑出血的独立危险因素(P<0.05)。结论治疗前NIHSS评分高及合并房颤是ACI溶栓后脑出血的独立危险因素,临床应据此为患者实施针对性预防及干预措施,对降低溶栓后脑出血发生率,改善患者预后有重要意义。

Objective To analyze the risk factors for cerebral hemorrhage after thrombolysis in patients with acute cerebral infarction（ACI） in order to explore appropriate preventive measures. Methods A total of 182 patients with ACI to receive treatment in our hospital were selected as study subjects and treated with thrombolytic therapy after admission. The incidence of cerebral hemorrhage after thrombolysis was calculated. Single-and multi-factor analysis and logistic regression analysis were conducted on the influence factors for cerebral hemorrhage after ACI thrombolysis. Reasonable preventive measures were explored. Results Among the182 patients treated with thrombolysis, 62 patients had cerebral hemorrhage, with an incidence of 34.07%. The results of single-factor analysis showed that the age, pre-treatment NIHSS score, AF and cardiogenic cerebral embolism composition ratio in the hemorrhage group were significantly higher than those in the non-hemorrhage group, and the time from the attack to venous thrombolytic therapy was much longer than that in the non-hemorrhage group（P 〈 0.05）; the results of logistics regression analysis showed that the ultrahigh pre-treatment NIHSS score and the complication of AF were independent risk factors for cerebral hemorrhage after ACI thrombolysis（P 〈 0.05）. Conclusion The ultra-high pre-treatment NIHSS score and the complication of AF are independent risk factors for cerebral hemorrhage after ACI thrombolysis, thus targeted preventive and intervening measures should be clinically taken for patients accordingly, which is of great significance for lowering the incidence of cerebral hemorrhage after thrombolysis and improving patients＇ prognosis.