脑梗死患者发生梗死后出血转化的临床特征及危险因素分析

Clinical Characteristics and Risk Factors of Hemorrhagic Transformation in Patients with Cerebral Infarction

目的研究脑梗死患者发生梗死后出血转化的临床特征及危险因素。方法选取2018年5月—2019年5月于我院接受治疗的脑梗死200例,根据是否发生梗死后出血转化分为出血转化组116例和非出血转化组84例。比较2组既往病史、抗凝及溶栓治疗、大面积脑梗死;检测并比较2组血脂[高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)]、空腹血糖(FBG)及血压水平。结果出血转化组有糖尿病、高脂血症、高血压病、心房颤动、卒中史和饮酒史比例高于非出血转化组(P<0.05)。出血转化组接受抗凝治疗、溶栓治疗的患者比例高于非出血转化组(P<0.05);出血转化组中大面积脑梗死患者比例高于非出血转化组(P<0.05)。出血转化组HDL-C、LDL-C、TG、TC水平低于非出血转化组,FBG、收缩压、舒张压水平均高于非出血转化组,差异有统计学意义(P<0.05,P<0.01)。饮酒史和糖尿病史、高脂血症史、高血压病史、心房颤动病史、卒中史、抗凝治疗、溶栓治疗、梗死面积为脑梗死发生出血转化的危险因素。结论饮酒史和糖尿病史、高脂血症史、高血压病史、心房颤动病史、卒中史、抗凝治疗、溶栓治疗、梗死面积为脑梗死发生出血转化的危险因素,积极进行干预,对提高疗效及改善预后具有重要意义。

Objective To study clinical characteristics and risk factors of hemorrhage transformation(HT)in patients with cerebral infarction.Methods A total of 200 patients with cerebral infarction treated between May 2018 and May 2019 were selected and divided into HT group(n=116)and non-HT group(n=84)according to presence or absence of HT after onset of the disease.In two groups,past medical history,anticoagulant therapy,thrombolytic therapy and area of cerebral infarct were compared,and levels of blood lipids[high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC)],fasting blood glucose(FBG)and blood pressure were detected and compared.Results Proportions of patients with past histories of diabetes,hyperlipidemia,hypertensive disease,atrial fibrillation and stroke and drinking in HT group were significantly higher than those in non-HT group(P<0.05).Proportions of patients receiving anticoagulant therapy and thrombolytic therapy in HT group were significantly higher than those in non-HT group(P<0.05).Proportion of patients with large area of cerebral infarct in HT group was significantly higher than that in non-HT group(P<0.05).In HT group,levels of HDL-C,LDL-C,TG and TC were significantly lower,while levels of FBG,SBP and DBP were significantly higher than those in non-HT group(P<0.05,P<0.01).Drinking history,diabetes history,hyperlipidemia history,hypertensive disease history,atrial fibrillation history,stroke history,anticoagulant therapy,thrombolysis therapy and area of cerebral infarct were risk factors of HT in patients with cerebral infarction.Conclusion Drinking history,diabetes history,hyperlipidemia history,hypertensive disease history,atrial fibrillation history,stroke history,anticoagulation therapy,thrombolysis therapy and area of cerebral infarct are risk factors for pathogenesy of HT in patients with cerebral infarction.Active intervention is of great significance in improving therapeutic effect and prognoses of HT in patients with cerebral infarction.