335例急性脑梗死患者出血转化的危险因素探讨

发布时间：2018-07-26 14:53

【摘要】：目的探讨急性脑梗死患者出血转化(HT)的危险因素。方法收集2013年6月至2016年9月于该院住院治疗且资料完整的急性脑梗死患者335例,其中HT组47例,非HT组(NHT组)288例。收集并比较两组患者一般临床情况、实验室检查指标、影像学特点及治疗措施的差异,应用Logistic回归分析筛选急性脑梗死患者HT的危险因素。结果单因素分析显示,两组患者在糖尿病史、心房颤动病史、神经功能评分(NHISS评分)、入院收缩压、空腹血糖、糖化血红蛋白、低密度脂蛋白胆固醇、纤维蛋白原、梗死部位、大面积梗死及溶栓治疗等方面差异有统计学意义(P0.05)。Logistic回归分析显示,心房颤动病史(OR=2.703,95%CI1.169~6.250)、高空腹血糖(OR=2.098,95%CI 1.532~2.875)、大面积脑梗死(OR=9.999,95%CI4.648~21.510)及溶栓治疗(OR=6.557,95%CI1.954~22.003)是HT的独立危险因素。结论心房颤动病史、高空腹血糖、大面积脑梗死及溶栓治疗是发生脑梗死后出血转化的危险因素,需安排相应的护理措施以利于疾病治疗。
[Abstract]:Objective to investigate the risk factors of hemorrhagic transformation (HT) in patients with acute cerebral infarction. Methods 335 cases of acute cerebral infarction were collected in the hospital from June 2013 to September 2016, including 47 cases in group HT and 288 cases in non HT group (group NHT). The general clinical conditions, laboratory examination indexes, imaging characteristics and treatment of the two groups were collected and compared. Logistic regression analysis was used to screen the risk factors of HT in patients with acute cerebral infarction. Results single factor analysis showed that two groups of patients were in the history of diabetes, atrial fibrillation, neurological function score (NHISS score), systolic blood pressure, fasting blood glucose, glycosylated hemoglobin, low density lipoprotein cholesterol, fibrinogen, infarct Position, large area infarction and thrombolytic therapy were statistically significant (P0.05).Logistic regression analysis showed that the history of atrial fibrillation (OR=2.703,95%CI1.169~6.250), high altitude abdominal blood glucose (OR=2.098,95%CI 1.532~2.875), large area cerebral infarction (OR=9.999,95%CI4.648~ 21.510) and thrombolytic therapy (OR=6.557,95%CI1.954~22.003) were independent risk of HT. Conclusion the history of atrial fibrillation, high altitude abdominal blood glucose, large area cerebral infarction and thrombolytic therapy are the risk factors for the transformation of hemorrhage after cerebral infarction. The corresponding nursing measures should be arranged to help the treatment of the disease.
【作者单位】：河北省唐山市工人医院神经内科;河北省唐山市工人医院麻醉科;
【分类号】：R743.33

【相似文献】