摘要
目的 :探讨与急性脑梗死静脉溶栓治疗后继发脑出血 (ICH)有关的危险因素。方法 :82例急性脑梗死患者在发病 12 h内接受了尿激酶静脉溶栓治疗 ,选取溶栓前的临床和实验室资料作为 ICH的可能危险因素 ,分析与 ICH的关系。结果 :15例患者继发 ICH(18.3% ) ,其中 6例为出血性梗死 (7.3% ) ,9例为脑实质血肿(11.0 % )。发生症状性脑出血 (SICH) 7例 ,死亡 4例。统计学分析表明继发 ICH者有较低的神经功能缺损评分 (ESS) ,ESS评分 <6 0分、溶栓前头颅 CT可见早期缺血改变 (EIC)及存在心房纤颤的患者有更高的出血率。结论 :溶栓前的神经功能缺损程度、CT早期缺血改变和心房纤颤是 ICH的危险因素。
Objective: To identify risk factors of intracerebral hemorrhage (ICH) after intravenous thrombolysis in acute cerebral infarction. Methods: Eighty-two patients with acute cerebral infarction were treated with intravenous urokinase within 12 hours from stroke onset. The data of clinic and laboratory were as readily available baseline factors and were analyzed to select potential contributors to ICH. Results: ICH occurred in 15 patients (18.3%), including 6 hemorrhagic infarction (HI, 7.3%) and 9 parenchymal hemorrhage (PH, 11.0%). Seven patients had symptomatic ICH, and 4 patients died. Patients with ICH had significantly lower European stroke scale (ESS) scores. Patients with ESS<60 scores, early ischemic changes (EIC) on cranial CT scans or artrial fibrillation had significantly higher risk of ICH. Conclusion: Risk factors associated with ICH are severity of neurological deficit, EIC and artrial fibrillation.
出处
《中国危重病急救医学》
CAS
CSCD
2003年第10期631-633,共3页
Chinese Critical Care Medicine
基金
"九五"国家医学重点科技项目 (攻关 )计划专题基金资助 ( 9690 60 2 2 2 )
关键词
血栓溶解疗法
脑梗死
脑出血
危险因素
thrombolytic therapy
cerebral infarction
intracerebral hemorrhage
risk factors
