摘要
目的:探讨急性脑梗死患者使用阿替普酶静脉溶栓后发生出血性转化(HT)的相关因素。方法:回顾性分析2014年1月至2017年1月收治的124例急性脑梗死患者的临床资料,均采用阿替普酶静脉溶栓治疗。探讨溶栓后发生HT的情况及其可能的影响因素。结果:21例患者溶栓后24~72h发生HT,发生率16.94%,其中HI-1型9例,HI-2型6例,PH-1型3例,PH-2型3例;有症状的颅内出血5例。多因素Logistic回归分析结果显示:合并心房纤颤、基线NIHSS评分、基线血糖,溶栓后12h收缩压为HT的独立危险因素(P<0.05)。结论:对于阿替普酶静脉溶栓后的急性脑梗死患者,合并心房纤颤、溶栓前高血糖、高NIHSS评分及溶栓后收缩压控制不佳可使其患HT的风险增高,临床上应加以重视。
Objective： To analyze the related factors of hemorrhagic transformation （HT） after intravenous thromholytic therapy with alteplase in patients with acute cerebral infarction. Methods： 124 patients with acute cerebral infarction treated with intravenous thrombolytic therapy with alteplase were collected and the clinical data were analyzed retrospectively. The possible influencing factors of HT after thrombolysis were investigated. Results： A total of 21 patients in the group of patients developed HT after thrombolysis from 24 to 72 h, the incidence rate of HT was 16.94% . Among them, 9 cases were type HI-1, 6 cases were HI- 2 type, 3 cases were PH-1 type, and two cases were type PH-2, 5 cases were symptomatic intracranial hemorrhage. Multivariate logistic regression analysis showed that atrial fibrillation, baseline NIHSS score, baseline blood glucose, and 12 h systolic blood pressure were independent risk factors for HT. Conclusion： For patients with acute cerebral infarction after intravenous thrombolysis with alteplase, atrial fibrillation, high blood sugar before thrombolysis, high NIHSS score and poor control of systolic blood pressure after thrombolysis could increase the risk of developing HT.
出处
《广西医科大学学报》
CAS
2017年第7期1009-1012,共4页
Journal of Guangxi Medical University
基金
北京市石景山医院基金资助项目(No.2014-05)
关键词
急性脑梗死
静脉溶栓
阿替普酶
出血性转化
acute cerebral infarction
intravenous thrombolysis
alteplase
hemorrhagic transformation
