急性缺血性脑卒中静脉溶栓后出血性转化危险因素分析

被引:35
作者
黄银辉 [1 ]
李明媚 [2 ]
陈振杰 [2 ]
林友榆 [1 ]
欧阳宛炯 [3 ]
卓识途 [3 ]
蔡若蔚 [3 ]
机构
[1] 福建省晋江市医院神经内科
[2] 福建省安溪县铭选医院神经内科
[3] 福建医科大学附属第二医院神经内科
关键词
静脉溶栓; 急性缺血性脑卒中; 出血性转化; 因素;
D O I
暂无
中图分类号
R743.3 [急性脑血管疾病(中风)];
学科分类号
1002 ;
摘要
目的探讨急性缺血性脑卒中患者静脉溶栓后出血性转化(hemorrhagic transformation,HT)的危险因素。方法回顾性分析接受静脉溶栓治疗的171例急性缺血性脑卒中患者按治疗后7 d内行头颅CT检查,根据头颅有无出血性转化分为HT组及无HT组,比较两组患者的临床资料,采用单因素和Logistic回归分析静脉溶栓治疗后出血性转化的危险因素。结果HT组(33例)与无HT组(138例)相比,既往有糖尿病者较多(P=0.008),溶栓前头颅CT有早期缺血改变者较多(P=0.040),溶栓前美国卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分较高(P=0.033),起病-溶栓时间(onset to treatment time,OTT)较长(P=0.043),溶栓后2 h收缩压、24 h收缩压、24 h舒张压较高(P=0.008、P=0.049、P=0.002)。Logistic回归分析表明溶栓前头颅CT有早期缺血改变者、溶栓前NIHSS评分高、溶栓后2 h及24 h收缩压高者与溶栓后HT发生显著相关。结论溶栓前头颅CT有早期缺血改变、溶栓前NIHSS评分的分值偏高、溶栓后2 h及24 h收缩压偏高是溶栓后HT的危险因素。
引用
收藏
页码:581 / 586
页数:6
相关论文
共 16 条
[1]   急性基底动脉闭塞溶栓早期临床预后分析 [J].
徐安定 ;
唐敬敬 ;
李牧 ;
辛秀峰 ;
杨万勇 ;
刘小艳 .
中国神经精神疾病杂志, 2012, 38 (05) :289-293
[2]   急性缺血性脑卒中患者出血转化与血脂水平的关系 [J].
汤媛媛 ;
秦超 ;
梁志坚 ;
赵伟佳 ;
李茂 ;
龙莉玲 .
中国神经精神疾病杂志, 2011, 37 (12) :740-743
[3]   急性脑梗死静脉溶栓后脑出血的危险因素分析 [J].
李斗 ;
雷燕妮 .
中国危重病急救医学, 2003, (10) :631-633
[5]  
Racial Disparities in Tissue Plasminogen Activator Treatment Rate for Stroke: A Population-Based Study[J] . Amie W. Hsia,Dorothy F. Edwards,Lewis B. Morgenstern,Jeffrey J. Wing,Nina C. Brown,Regina Coles,Sarah Loftin,Andrea Wein,Sara S. Koslosky,Sabiha Fatima,Brisa N. Sánchez,Ali Fokar,M. Chris Gibbons,Nawar Shara,Annapurni Jayam-Trouth,Chelsea S. Kidwell.Stroke . 2011 (8)
[6]   Analysis of the National Institute of Neurological Disorders and Stroke Tissue Plasminogen Activator Studies Following European Cooperative Acute Stroke Study III Patient Selection Criteria [J].
Hemmen, Thomas M. ;
Rapp, Karen S. ;
Emond, Jennifer A. ;
Raman, Rema ;
Lyden, Patrick D. .
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, 2010, 19 (04) :290-293
[7]   Intravenous Tissue Plasminogen Activator Thrombolysis in Patients With Diabetes Mellitus and Previous Stroke [J].
Gonzalez-Hernandez, Ayoze N. ;
Fabre-Pi, Oscar ;
Lopez-Fernandez, Juan C. ;
Diaz-Nicolas, Santiago .
STROKE, 2009, 40 (12) :E707-E707
[8]  
Relationship of Blood Pressure, Antihypertensive Therapy, and Outcome in Ischemic Stroke Treated With Intravenous Thrombolysis: Retrospective Analysis From Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR)[J] . Niaz Ahmed,Nils Wahlgren,Michael Brainin,José Castillo,Gary A. Ford,Markku Kaste,Kennedy R. Lees,Danilo Toni.Stroke . 2009 (7)
[9]  
Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educati[J] . Harold P. Adams,Gregory del Zoppo,Mark J. Al
[10]   Pretreatment hemostatic markers of symptomatic intracerebral hemorrhage in patients treated with tissue plasminogen activator [J].
Cocho, D ;
Borrell, M ;
Martí-Fàbregas, J ;
Montaner, J ;
Castellanos, M ;
Bravo, Y ;
Molina-Porcel, L ;
Belvís, R ;
Díaz-Manera, JA ;
Martínez-Domeño, A ;
Martínez-Lage, M ;
Millán, M ;
Fontcuberta, J ;
Martí-Vilalta, JL .
STROKE, 2006, 37 (04) :996-999