急性脑梗死患者桥接治疗出血转化的相关因素

Related factors of hemorrhagic transformation of bridging therapy in patients with acute cerebral infarction

目的研究急性脑梗死患者桥接治疗出血转化的相关因素。方法收集60例桥接治疗后出血转化的急性脑梗死患者(出血转化组)及无出血转化的70例急性脑梗死患者(无出血转化组)的临床资料,分析急性脑梗死桥接治疗出血转化的相关影响因素。结果与无出血转化组比较,出血转化组大面积脑梗死、糖尿病及NIHSS评分≥18分比率显著升高(均P<0.05),侧支循环建立比率显著降低(P<0.05)。与无出血转化组比较,出血转化组发病至溶栓时间、发病至穿刺时间、穿刺至血管开通时间显著升高(均P<0.05)。Logistic分析显示,糖尿病、大面积脑梗死、侧支循环未建立、发病至溶栓时间、发病至穿刺时间、穿刺至血管开通时间是缺血性卒中桥接治疗出血转化的独立危险因素(均P<0.05)。结论糖尿病、大面积脑梗死、侧支循环未建立、发病至溶栓时间、发病至穿刺时间、穿刺至血管开通时间是急性脑梗死桥接治疗出血转化的独立危险因素。

Objective To investigate the related factors of hemorrhagic transformation of bridging therapy in patients with acute cerebral infarction. Methods Clinical data of 60 cases of acute cerebral infarction patients with hemorrhage transformation after bridging therapy(hemorrhage transformation group) and 70 cases of acute cerebral infarction patients without hemorrhage transformation(no hemorrhage transformation group) were collected, and the related factors of hemorrhagic transformation of bridging therapy were analyzed. Results Compared with those in no hemorrhage transformation group, the rates of massive cerebral infarction, diabetes and the NIHSS score≥18 were significantly increased in hemorrhage transformation group(all P<0.05), the rate of collateral circulation establishment was significantly decreased(P<0.05). Compared with those in no hemorrhage transformation group, the time from onset to starting thrombolysis, the time from onset to puncture and the time from puncture to vessel opening were significantly increased in hemorrhage transformation group(all P<0.05). Logistic analysis showed that diabetes, massive cerebral infarction, absence of collateral circulation, the time from onset to starting thrombolysis, the time from onset to puncture and the time from puncture to vessel opening were independent risk factors of hemorrhage transformation of bridging therapy in ischemic stroke(all P<0.05).Conclusions Diabetes, massive cerebral infarction, absence of collateral circulation, the time from onset to starting thrombolysis, the time from onset to puncture and the time from puncture to vessel opening are independent risk factors of hemorrhage transformation of bridging therapy in acute cerebral infarction.