头颅MRI指导的rt-PA静脉溶栓后脑出血的危险因素

The risk factors of intracerebral hemorrhage resulting from rt-PA intravenous thrombolysis guided by cerebral magnetic resonance imaging

目的 确定头颅MRI指导的rt-PA静脉溶栓后脑出血的危险因素。方法 收集rt-PA静脉溶栓患者临床数据,分析出血组和未出血组诸因素有无统计学差异。结果 与未出血组相比,头颅MRI指导的静脉溶栓后出血组溶栓前NIHSS、溶栓合并取栓、发病至溶栓时间>4.5h,P<0.05。而多因素回归分析发现重度脑梗死(NIHSS≥21分)、溶栓合并取栓是头颅MRI指导的静脉溶栓患者脑出血的独立危险因素。结论 头颅MRI指导的rt-PA静脉溶栓后脑出血的独立危险因素为重度脑卒中(NIHSS≥21分)和溶栓合并取栓,而与其他因素无关。

Objective To identify the risk factors of intracerebral hemorrhage resulting from rt-PA intravenous thrombolysis guided by cerebral magnetic resonance imaging(MRI).Methods The clinical data of patients treated with rt-PA intravenous thrombolysis guided by cerebral MRI were consecutively collected,to analyze whether there were any difference between the intracerebral hemorrhage group and non-intracerebral hemorrhage group.Results Compared with non-intracerebral hemorrhage group,Baseline NIHSS,thrombolysis combined with thrombectomy and time of onset to thrombolysis4.5h,P 0.05.Multivariate Logistic analysis revealed that severe cerebral infarction(NIHSS≥21)and thrombolysis combined with thrombectomy were the independent risk factors of intracerebral hemorrhage resulting from intravenous thrombolysis guided by cerebral MRI.Conclusion Severe cerebral infarction(NIHSS≥21)and thrombolysis combined with thrombectomy were the independent risk factors of intracerebral hemorrhage resulting from intravenous thrombolysis guided by cerebral MRI.While other factors were not associated with it.