磁敏感加权成像对缺血性卒中患者二级预防发生脑出血风险的预测作用
发布时间：2018-08-03 21:44
【摘要】：目的:利用磁敏感加权成像技术(SWI)检测缺血性卒中患者脑微出血(CMBs)的数目和部位,探讨二级预防中脑微出的部位和数目对未来发生脑出血风险的预测价值。方法:本前瞻性病例对照研究,纳入2015年5月至2016年4月期间,因急性脑梗死就诊于新疆维吾尔自治区人民医院神经内科的患者,将所有纳入的患者行SWI检查,记录CMBs数目和部位。根据发病机制均口服单一抗血小板聚集药物(阿司匹林肠溶片100mg或氯吡格雷片75mg),6个月后电话或门诊随访。终点事件是发生了脑出血(ICH)、复发脑梗死和其他。结果:共纳入了94例患者,其中发现伴CMBs患者50(53.2%)例,平均随访6.23±0.7月,发现发生脑出血的风险与CMBs的数目明显相关:0%(没有CMBs),6.7%(1个CMBs),9.1%(2-4个CMBs),15.4%(≥5个CMBs)(P=0.015)。复发脑梗死的风险分别是9.1%,6.7%,22.1%,7.7%(P=0.327)。结论:未来脑出血(ICH)的发病率与CMBs的数目明显相关,当患者CMBs数目≥5个时,发生脑出血的风险高于服用抗血小板聚集药物带来的益处。并且从总体上来看,未来脑梗死的复发率仍高于脑出血,所以,抗血小板聚集药物作为缺血性卒中患者二级预防的基石之一,继续服用抗血小板聚集药物仍然是必要的。作为临床医生应对CMBs有足够的重视,应积极采取干预措施,以平衡未来发生抗血小板聚集药物相关性脑出血和复发脑梗死的风险。
[Abstract]:Objective: to detect the number and location of cerebral microhemorrhage (CMBs) in ischemic stroke patients by magnetic sensitivity weighted imaging (SWI), and to explore the predictive value of the number and number of secondary prevention sites and numbers for the risk of intracerebral hemorrhage (ICH) in the future. Methods: this prospective case-control study included patients with acute cerebral infarction who were admitted to the Department of Neurology of the people's Hospital of Xinjiang Uygur Autonomous region from May 2015 to April 2016. All patients were examined by SWI. The number and location of CMBs were recorded. All patients were treated with single antiplatelet aggregation drugs (aspirin enteric-coated tablets 100mg or clopidogrel 75mg) according to the pathogenesis and followed up 6 months later by telephone or outpatient. The endpoint event is the occurrence of intracerebral hemorrhage, (ICH), recurrence, cerebral infarction and other. Results: a total of 94 patients were included, of whom 50 (53.2%) were found to be with CMBs, with an average follow-up of 6.23 卤0.7 months. It was found that the risk of intracerebral hemorrhage was significantly correlated with the number of CMBs: 0% (without CMBs), 6.7% (1 CMBs) or 9.1% (2-4 CMBs) (鈮，
本文编号：2163082
[Abstract]:Objective: to detect the number and location of cerebral microhemorrhage (CMBs) in ischemic stroke patients by magnetic sensitivity weighted imaging (SWI), and to explore the predictive value of the number and number of secondary prevention sites and numbers for the risk of intracerebral hemorrhage (ICH) in the future. Methods: this prospective case-control study included patients with acute cerebral infarction who were admitted to the Department of Neurology of the people's Hospital of Xinjiang Uygur Autonomous region from May 2015 to April 2016. All patients were examined by SWI. The number and location of CMBs were recorded. All patients were treated with single antiplatelet aggregation drugs (aspirin enteric-coated tablets 100mg or clopidogrel 75mg) according to the pathogenesis and followed up 6 months later by telephone or outpatient. The endpoint event is the occurrence of intracerebral hemorrhage, (ICH), recurrence, cerebral infarction and other. Results: a total of 94 patients were included, of whom 50 (53.2%) were found to be with CMBs, with an average follow-up of 6.23 卤0.7 months. It was found that the risk of intracerebral hemorrhage was significantly correlated with the number of CMBs: 0% (without CMBs), 6.7% (1 CMBs) or 9.1% (2-4 CMBs) (鈮，
本文编号：2163082
本文链接：https://www.wllwen.com/yixuelunwen/shenjingyixue/2163082.html
最近更新
教材专著
