SEDAN评分对rt-PA静脉溶栓治疗急性缺血性卒中后出血转化的预测价值研究

Study on the predictive value of SEDAN score in rt-PA intravenous thrombolytic therapy for hemorrhagic transformation after acute ischemic stroke

目的探讨静脉溶栓后症状性脑出血风险(SEDAN)评分对急性缺血性卒中(AIS)患者接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗后急性期内发生出血转化(HT)的预测价值。方法回顾性分析2019年1月至2020年12月急诊收入的接受rt-PA静脉溶栓治疗的AIS患者的临床资料,以SEDAN评分结果进行分组,记录比较各组患者发生HT的情况。结果共纳入191例患者,有40例患者出现HT,其中18例为无症状性出血,16例为症状性出血,6例为致死性出血。不同分组间HT发生率比较,差异有统计学意义(χ^(2)=63.174,P<0.001),Spearman等级相关分析结果显示,SEDAN评分与溶栓后出血转化间有相关性(相关系数为0.399,P<0.001)。结论对于接受rt-PA静脉溶栓的AIS患者,随着SEDAN分值的增加,发生HT的比例及严重程度增加。SEDAN评分可作为用于预测AIS患者接受rt-PA静脉溶栓后发生HT的一个简便易行的实用工具。

Objective To explore the value of risk score of hemorrhagic transformation after intravenous thrombolysis(SEDAN)of predicting hemorrhagic transformation(HT)risk in patients with acute ischemic stroke(AIS)who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator(rt-PA).Methods The clinical data of AIS patients who received rt-PA intravenous thrombolytic therapy from January 2019 to December 2020 were collected retrospectively.The SEDAN scores were used to group the patients,and the incidence of HT in each group was recorded and compared.Results A total of 191 patients were enrolled.There were 40 patients with HT,of which 18 were asymptomatic intracranial hemorrhage,16 were symptomatic intracranial hemorrhage,and 6 were fatal intracranial hemorrhage.There was significant difference of HT incidence among each groups(χ^(2)=63.174,P<0.001).Spearman correlation analysis showed that SEDAN score was positively correlated with the incidence of HT(correlation coefficient was 0.399,P<0.001).Conclusion For AIS patients who treated with rt-PA,as the SEDAN score increased,the incidence and severity of HT increased.The SEDAN score is a simple and practical tool to predict the incidence of HT in AIS patients treated with rt-PA.