脑梗死静脉溶栓治疗后出血性转化及其预后的危险因素分析

被引：27

作者：

李丽

机构：

[1] 山西晋城晋煤集团总医院

来源：

中西医结合心脑血管病杂志 | 2015年 / 13卷 / 06期

关键词：

脑梗死; 组织型纤溶酶原激活物; 溶栓; 出血性转化; 预后;

D O I：

暂无

中图分类号：

R743 [脑血管疾病];

学科分类号：

1002 ;

摘要：

目的探讨脑梗死患者重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后发生出血性转化(HT)的可能危险因素以及这些危险因素对患者预后的影响。方法 116例急性缺血性卒中患者发病6h内接受rt-PA静脉溶栓治疗,比较HT组与非HT组之间的差异,筛选与HT相关的可能危险因素,并进一步通过Logistic回归分析影响HT及其预后的独立危险因素。结果 116例溶栓患者中有22例继发HT(18.99%),其中16例为症状性脑出血。回归分析表明早期CT改变、基线舒张压≥100mmHg、基线血糖≥11.1mmol/L、NIHSS评分>15分和溶栓时间窗>3h、年龄6项为HT独立危险因素;其中基线血糖≥11.1mmol/L、NIHSS评分>15分和溶栓时间窗>3h影响了HT患者的预后。结论溶栓前的舒张压、血糖水平、神经功能缺损程度、CT低密度改变或水肿占位效应、溶栓时间窗、年龄是HT的独立危险因素,其中基线血糖水平、神经功能缺损程度和溶栓时间窗影响了溶栓后HT患者的预后。

引用

页码：837 / 839

页数：3

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