中重度脑白质疏松对急性脑梗死静脉溶栓患者出血转化及预后的影响

Effect of Moderate to Severe Leukoaraiosis on Hemorrhagic Transformation and Prognosis in Patients with Acute Cerebral Infarction Treated with Intravenous Thrombolysis

目的:分析中重度脑白质疏松对急性脑梗死静脉溶栓患者出血转化及预后造成的影响。方法:抽选2019年1月至2020年6月期间于本院进行静脉溶栓治疗患者100例,其中50例急性脑梗死+中重度脑白质疏松患者,设为研究组;50例急性脑梗死但无脑白质疏松患者,设为对照组。分析两组患者的临床资料,比较脑出血转化率及溶栓前和溶栓3个月后患者的FMS运动功能、NIHSS神经功能评分。结果:将溶栓前患者NIHSS评分和FMS评分纳入组间对比,统计学对比无差异(P>0.05);溶栓3个月后,研究组NIHSS评分为(11.34±3.21)分,高于对照组(6.82±1.33)分,两组比较有统计学差异(t=9.198,P=0.000);研究组FMS评分为(12.55±5.27)分,比对照组的(19.34±4.87)分低,统计学对比有明显差异(t=-6.691,P=0.000);研究组脑出血转化率为42.00%,高于对照组脑出血转化率16.00%,两组比较差异具有统计学意义(χ2=8.208,P=0.004)。结论:中重度脑白质疏松可使急性脑梗死静脉溶栓患者脑出血转化率提高,神经功能受损程度加重,运动功能变差,预后不佳。

Objective:To analyze the effect of moderate and severe leukoaraiosis on hemorrhagic transformation and prognosis of patients with acute cerebral infarction treated with intravenous thrombolysis.Methods:100 patients who underwent intravenous thrombolysis in our hospital from January 2019 to June 2020 were selected,of which 50 patients with acute cerebral infarction+moderate and severe leukoaraiosis were set as the study group;50 patients with acute cerebral infarction but no leukoaraiosis were set as the control group.The clinical data of the two groups were analyzed,and the conversion rate of intracerebral hemorrhage,FMS motor function and NIHSS neurological function scores of the patients before and 3 months after thrombolysis were compared.Results:The NIHSS score and FMS score of patients before thrombolysis were included in the comparison between groups,and there was no statistical difference(P>0.05).After 3 months of thrombolysis,the NIHSS score of the study group was(11.34±3.21)points,which was higher than that of the control group(6.82±1.33),there was statistically significant difference between the two groups(t=9.198,P=0.000);the FMS score of the study group(12.55±5.27)points,which was lower than that of the control group(19.34±4.87),and the difference was statistically significant(t=-6.691,P=0.000).The conversion rate of cerebral hemorrhage in the study group was 42.00%,which was higher than that in the control group(16.00%),and the difference was statistically significant(χ2=8.208,P=0.004).Conclusion:Moderate and severe leukoaraiosis can increase the conversion rate of cerebral hemorrhage,aggravate the degree of neurological impairment,worsen motor function and poor prognosis in patients with acute cerebral infarction undergoing intravenous thrombolysis.