尿激酶溶栓治疗后脑梗死患者颅内出血的相关影响因素分析

目的 探讨尿激酶溶栓治疗后脑梗死患者颅内出血的相关影响因素.方法 选择重庆市长寿区人民医院2012年1月至2015年9月收治的脑梗死溶栓治疗患者280例,按住院期间头部CT或头部MRI检查是否有颅内出血分为出血组(52例)和非出血组(228例).对可能导致脑梗死患者颅内出血的相关因素进行单因素分析和多元logisic回归分析.结果 280例脑梗死患者颅内出血发生率18.57%(52/280).单因素分析显示:脉压差、房颤史、入院NIHSS评分、早期缺血改变、入院血糖水平、入院MRS评分和超敏C反应蛋白是引起颅内出血的可能影响因素(P<0.05).多因素logisic回归分析表明,入院血糖水平、房颤史、早期缺血改变和入院NIHSS评分是预后的独立危险因素.结论 患者入院NIHSS评分高、血糖水平高,有房颤史、早期缺血改变是脑梗死患者发生颅内出血的危险因素.

Analysis of related factors of intracranial hemorrhage after urokinase thrombolytic therapy in patients with cerebral infarction

Objective To investigate the related factors of intracranial hemorrhage after urokinase thrombolytic therapy in the pa-tients with cerebral infarction. Methods 280 patients with cerebral infarction, ever treated by thrombolytic therapy in our hospital from Jan 2012 to Sep 2015, were selected and divided into the bleeding group (52 cases) and the non-bleeding group (228 cases) according to in-tracranial hemorrhage or not examined by head CT or MRI during hospital. Single factor analysis and multivariate logistic regression analysis were performed to analyze the related risk factors of intracranial hemorrhage in these patients with cerebral infarction. Results In the 280 pa-tients with cerebral infarction, the incidence rate of intracranial hemorrhage was 18. 57%. Single factor analysis showed that in the compari-son between the two groups, differences of seven risk factors, which were pulse pressure, history of atrial fibrillation, NIHSS scores on admis-sion, early ischemic changes, glucose levels on admission, MRS scores on admission and high sensitive CRP levels, were statistically signifi-cant (all P<0. 05). Multivariate logistic regression analysis showed that glucose levels on admission, history of atrial fibrillation, early is-chemic changes and NIHSS scores on admission were independent risk factors for the prognosis of intracranial hemorrhage. Conclusion The higher NIHSS scores and blood glucose levels on admission, history of atrial fibrillation and early ischemic changes would be the risk factors of intracranial hemorrhage in the patients with cerebral infarction.