中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (12): 1101-1104,1110.doi: 10.12007/j.issn.0258-4646.2017.12.010

• 论著 • 上一篇    下一篇

急性脑梗死患者重组组织型纤溶酶原激活剂静脉溶栓后出血性转化的危险因素分析

周秉博1,2, 王晓宏1, 杨军1   

  1. 1. 中国医科大学附属第一医院神经内科, 沈阳 110001;
    2. 抚顺市中心医院神经内科, 辽宁 抚顺 113006
  • 收稿日期:2017-02-27 出版日期:2017-12-30 发布日期:2017-12-08
  • 通讯作者: 王晓宏 E-mail:411926510@qq.com
  • 作者简介:周秉博(1977-),男,主治医师,硕士.

Analysis of Risk Factors of Hemorrhagic Transformation after Thrombolytic Therapy Using Recombinant Tissue Plasminogen Activator in Patients with Acute Ischemic Stroke

ZHOU Bingbo1,2, WANG Xiaohong1, YANG Jun1   

  1. 1. Department of Neurology, The First Hospital, China Medical University, Shenyang 110001, China;
    2. Department of Neurology, Central Hospital of Fushun City, Fushun 113006, China
  • Received:2017-02-27 Online:2017-12-30 Published:2017-12-08

摘要: 目的 探讨急性脑梗死患者静脉输注重组组织型纤溶酶原激活剂(rt-PA)后出血性转化的相关危险因素。方法 采用病例-对照研究的方法,选取21例急性脑梗死接受rt-PA静脉溶栓治疗后出现脑出血性转化者为病例组,并选择同一时期63例急性脑梗死接受rt-PA静脉溶栓治疗后未发生脑出血性转化者为对照组。应用单因素及多因素logistic回归分析溶栓后出血性转化的相关危险因素。结果 单因素分析结果显示,病例组中溶栓前美国国立卫生院卒中量表(NIHSS)评分>10分、高血压(溶栓前收缩压≥ 140 mmHg)、溶栓前血糖值升高、具有心房颤动史和脑血管疾病史的比例显著高于对照组。多因素logistic回归分析结果显示,溶栓前收缩压≥ 140 mmHg(OR=14.59,95% CI:1.63~130.95)、溶栓前血糖值升高(OR=9.92,95% CI:0.97~101.24)以及具有脑血管疾病史(OR=10.75,95% CI:1.76~65.78)是急性脑梗死患者接受rt-PA静脉溶栓后出血性转化的危险因素。结论 溶栓前收缩压≥ 140 mmHg、溶栓前血糖值升高以及具有脑血管疾病史是急性脑梗死患者接受rt-PA静脉溶栓后出血性转化的危险因素。

关键词: 脑梗死, 静脉溶栓, 出血转化, 危险因素

Abstract: Objective To investigate the risk factors associated with hemorrhagic transformation after administration of thrombolytic therapy using recombinant tissue plasminogen activator (rt-PA) in patients diagnosed with acute ischemic stroke. Methods The design for this research was a case-control study-21 patients with hemorrhagic transformation after administration of thrombolytic therapy using rt-PA were categorized as cases,and 63 patients without hemorrhagic transformation after administration of thrombolytic therapy using rt-PA were categorized as controls. Univariate and multivariate logistic regression analysis were performed to analyze the risk factors associated with hemorrhagic transformation after administration of thrombolytic therapy using rt-PA in patients diagnosed with acute ischemic stroke. Results Results of univariate analysis showed that positive baseline National Institutes of Health Stroke Scale (NIHSS) scores > 10,hypertension,baseline systolic blood pressure (SBP) ≥ 140 mmHg,increased blood glucose level,history of atrial fibrillation,and cerebrovascular disease (CVD) were significantly higher in the case group than in the control group. Results of multivariate logistic regression analysis showed that baseline SBP ≥ 140 mmHg (OR=14.59,95% CI:1.63-130.95),increased blood glucose level (OR=9.92,95% CI:0.97-101.24),and history of CVD (OR=10.75,95% CI:1.76-65.78) were independent risk factors associated with hemorrhagic transformation after administration of thrombolytic therapy using rt-PA in patients diagnosed with acute ischemic stroke. Conclusion Baseline SBP ≥ 140 mmHg,increased blood glucose level,and history of CVD were observed to be independent risk factors associated with hemorrhagic transformation after administration of thrombolytic therapy using rt-PA in patients diagnosed with acute ischemic stroke.

Key words: ischemic stroke, thrombolytic therapy, hemorrhagic transformation, risk factor

中图分类号: 

  • R743.3
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