摘要
目的：探讨急性脑梗死后非溶栓患者出血转化（HT）的危险因素。方法：回顾性选取我院确诊为急性脑梗死的非溶栓患者180例,根据是否出现继发性出血,将患者分成出血转化组（HT组,n=52）和非出血转化组（NHT组,n=128）,收集患者的相关资料：一般信息包括性别、年龄、吸烟和饮酒史、糖尿病、高血压病、心肌梗死、心瓣膜病等既往病史;临床检查指标：空腹血糖、血清总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、梗死面积,将各指标进行单因素分析,其中差异有统计学意义的危险因素采用Logistic回归进行多因素分析。结果：2组患者的性别、年龄、高血压病、糖尿病、心肌梗死病史差异无统计学意义（P〉0.05）,吸烟史、饮酒史、心瓣膜病史差异有统计学意义（P〈0.05）。临床检测指标中空腹血糖、低密度脂蛋白、梗死面积在2组患者中的差异有统计学意义（P〈0.05,P〈0.01）,Logistic多因素回归分析显示,影响HT的危险程度排序为：低密度脂蛋白（OR=2.621,95%CI：1.246-5.323,P=0.009）、空腹血糖（OR=1.086,95%CI：1.033-2.124,P=0.007）、大面积脑梗死（OR=0.843,95%CI：1.146-2.897,P=0.015）。结论：非溶栓患者急性脑梗死后的HT是一个由多因素影响的复杂病理学过程,本研究发现空腹血糖、低密度脂蛋白、大面积脑梗死是影响HT发生的危险因素。
Objective：To explore relevant factors for hemorrhagic transformation in patients with Non-thrombolysis of acute cerebral infarction.Method：180patients with non-thrombolysis of acute cerebral infarction were divided into two groups according to whether the hemorrhagic transformation happens：hemorrhagic transformation group（HT,n=52）,and non-hemorrhagic transformation group（NHT,n=128）.The relevant general data of two groups includs：gender,age,smoking and drinking history,hypertension,diabetes,myocardial infarction and valvular heart disease history.Clinical examination indexes includs：fasting plasma glucose,serum total cholesterol（TC）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDLC）and infarction size.Firstly,all the above data were studied by single factor analysis.Then the statistically significant factors were analysed by Logistic regression methods.Result：HT patients were 52 cases of total 180 patients,so the incidence of HT is 28.9%.The age,hypertension,diabetes,myocardial infarction history between two groups had no significantly difference（P〉0.05）.But smoking and drinking history,valvular heart disease history between two groups had significantly difference（P〈0.05）.Among clinical examination indicators,fasting plasma glucose,low density lipoprotein（LDL）and infarction size had significantly difference（P〈0.05）.Multivariate logistic analysis indicated the order of risk degree affecting HT was fasting plasma glucose（OR=1.086,95%CI1.033-2.124,P=0.007）,low density lipoprotein（OR=2.621,95%CI 1.246-5.323,P=0.009）and infarction size（OR=0.843,95%CI1.146-2.897,P=0.015）.Conclusion：Hemorrhagic transformation in acute cerebral infarction with non-thrombolysis（HT）is a complex pathological process affected by multiple factors.Fasting plasma glucose,low density lipoprotein（LDL）and infarction size as risk factors are associated with the occurrence of HT.
出处
《临床急诊杂志》
CAS
2016年第2期118-120,共3页
Journal of Clinical Emergency
关键词
脑梗死
出血转化
危险因素
cerebral infarction
hemorrhagic transformation
risk factors
