阿替普酶静脉溶栓治疗急性脑梗死及出血转化的相关因素分析

Analysis of Related Factors in the Treatment of Acute Cerebral Infarction and Haemorrhagic Transformation by Intravenous Thrombolysis with Ateplase

目的评价阿替普酶静脉溶栓治疗急性脑梗死的效果以及出血转化的相关因素,从而提高急性脑梗患者治疗预后效果、预防和控制出血转化,进一步提高急性脑梗死患者的生活与生存质量。方法选择我院2017年7月至2018年12月收治住院抢救治疗的急性脑梗死患者(n=106),于4.5 h内静脉溶栓治疗,比较患者治疗前后神经功能缺损以及日常生活能力状况改善情况。并分析一般资料,总结导致出血转化的相关因素。结果治疗后对比治疗前急性脑梗死患者神经功能缺损、日常生活能力均明显改善,P<0.05。另外,一般资料分析后发现收缩压、舒张压、入院至静脉溶栓门诊时间、溶栓前NIHSS评分差异显著,具有统计学意义P<0.05。结论阿替普酶静脉溶栓治疗急性脑梗死整体效果显著,但是患者仍有出血风险,血压、溶栓前NIHSS评分等指标均为影响出血转化的危险因素,为了预防患者溶栓后出血转化需积极预防干预。

Objective To evaluate the effect of intravenous thrombolysis with ateplase in the treatment of acute cerebral infarction and the related factors of hemorrhage transformation,so as to improve the prognosis effect,prevent and control the hemorrhage transformation of patients with acute cerebral infarction,and further improve the quality of life and life of patients with acute cerebral infarction.Methods Patients with acute cerebral infarction(n=106)who were hospitalized in our hospital from July 2017 to December 2018 were treated with intravenous thrombolysis within 4.5 hours.The improvement of neurological deficit and daily living ability before and after treatment were compared.And analyze the general data,summarize the related factors that lead to the transformation of bleeding.Results After the treatment,the neurological deficit and the ability of daily life of the patients with acute cerebral infarction were significantly improved(P<0.05).In addition,after the analysis of general data,there were significant differences in systolic blood pressure,diastolic blood pressure,time from admission to intravenous thrombolysis,and NIHSS score before thrombolysis(P<0.05).Conclusion Intravenous thrombolysis with ateplase has a significant effect on acute cerebral infarction,but there is still a risk of bleeding in patients.Blood pressure,neurological deficit and other indicators are the risk factors of bleeding transformation.In order to prevent bleeding transformation after thrombolysis,active prevention and intervention are needed.