急性脑梗死静脉溶栓后早期脑出血转化的相关因素分析

Analysis of factors that related to the early cerebral hemorrhagic transformation after intravenous thrombolysis in patients with acute cerebral infarction

目的:探讨急性脑梗死静脉溶栓后早期脑出血转化的相关因素。方法:选取2012-01—2016-12期间我院收治的急性脑梗死患者287例,入组患者均采用静脉溶栓治疗,治疗后根据头颅CT或MRI检查结果分为脑出血转化组(48例)和无脑出血转化组(239例)。两组入院后完善相关检查,查阅患者病例搜集两组年龄、性别、高血压、糖尿病、同型半胱氨酸、梗死面积、发病到溶栓间隔时间、房颤及NIHSS评分等资料并进行单因素及多因素Logistic回归分析。结果:急性脑梗死患者287例患者中共48例发生脑出血转化,发生率为16.72%。脑出血转化类型相对较多,排在前两位的分别为52.08%和41.67%;单因素结果显示:急性脑梗死患者静脉溶栓后早期脑出血转化发生率与高血压史、同型半胱氨酸水平比较差异无统计学意义(P>0.05);急性脑梗死患者静脉溶栓后早期脑出血转化发生率与糖尿病史、梗死面积、发病到溶栓间隔时间、房颤及NIHSS评分关系密切(P<0.05);Logistic回归分析显示:急性脑梗死患者静脉溶栓后早期脑出血转化发生率与糖尿病史、梗死面积、发病到溶栓间隔时间、房颤及NIHSS评分关系密切(P<0.05)。结论:急性脑梗死静脉溶栓后早期脑出血转化危险因素相对较多,应根据危险因素制定相应的应对措施,降低脑出血转化率。

Objective：To investigate the related factors of early cerebral hemorrhage transformation after intravenous thrombolysis in patients with acute cerebral infarction.Method：Two hundred and eighty-seven patients with acute cerebral infarction from January 2012 to December 2016 admitted to the hospital and all the patients accepted intravenous thrombolytic therapy.After treatment,according to the head CT or MRI examination,the patients were divided into cerebral hemorrhage group（48 cases）and the conversion of non transformed intracerebral hemorrhage group（239 cases）.The relevant examination of 2 groups was completed after admission,the data of age,gender,hypertension,diabetes mellitus,homocysteine,infarct size,interval time of onset to thrombolysis,atrial fibrillation and NIHSS score data of the patients was collected and analyzed by method of Logistic univariate and multivariate logistic regression.Result：In 287 patients with acute cerebral infarction,48 patients suffered from cerebral hemorrhage transformation,the incidence was 16.72%.Cerebral hemorrhage transformation type was relatively various,the top two were 52.08%and 41.67%respectively;univariate results showed that there was no significant difference between the incidence of early cerebral hemorrhage transformation in acute cerebral infarction patients after intravenous thrombolysis and hypertension history,homocysteine level（P〉0.05）;both univariate results Logistic regression analysis showed and the incidence of early cerebral hemorrhage transformation in acute cerebral infarction patients after intravenous thrombolysis was siglificantly related to diabetes history,infarct size,interval time of onset to thrombolysis,atrial fibrillation and NIHSS score（P〈0.05）.Conclusion：The risk factors of early cerebral hemorrhage transformation after acute cerebral infarction thrombolysis are relatively various,and corresponding measures should be made according to risk factors,so as to reduce the conversion rate of cerebral hemorrhage.