利用SWI探讨急性脑梗死合并脑微出血静脉溶栓风险

目的：探讨急性脑梗死合并脑微出血(CMBs)的相关危险因素及静脉溶栓治疗后出血转化风险。方法收集164急性脑梗死患者,入院时均行常规 MRI 及 SWI 扫描,根据 SWI 上有无 CMBs 分为 CMBs 阳性组和 CMBs 阴性组,记录所有患者的一般临床资料,探讨 CMBs 的相关危险因素。静脉溶栓治疗后的76例患者,其中 CMBs 阳性组35例,CMBs 阴性组41例,分别计数2组患者 CMBs 数目增多或出现出血转化的例数。结果年龄、高血压病、腔隙性梗死、脑白质疏松与 CMBs 相关性显著(P <0.05)。静脉溶栓后2组患者间出血转化率差异无统计学意义(P >0.05)。结论性别、年龄、高血压病、腔隙性脑梗死、脑白质疏松是CMBs 的危险因素。急性脑梗死合并 CMBs 患者静脉溶栓治疗不会增加出血转化危险。

Risk analysis of intravenous thrombolysis in acute cerebral infarction with cerebral microbleeds by SWI

Objective To investigate the risk factors and the influence of intravenous thrombolysis of acute cerebral infarction with cerebral microbleeds(CMBs)by SWI.Methods 1 64 patients with acute cerebral infarction were enrolled in this study.All pa-tients were scanned with routine MRI and SWI.According to the presence of CMBs on SWI,the patients were classified into two groups:CMBs group(73 cases)and non-CMBs group(91 cases).Past history was recorded and risk factors of CMBs were explored. 76 cases patients(including 35 cases of CMBs group and 41 cases of non-CMBs group)were treated by intravenous thrombolysis and rescanned with routine MRI and SWI to compare the changes in the number of CMBs and hemorrhage transformation 24 hours after thrombolysis.Results The difference age,hypertension,lacunar infarction and leukoaraiosis between the two groups were significant (P <0.05).The difference of CMBs and hemorrhagic transformation between the two groups treated by thrombolysis were not sig-nificant(P >0.05).Conclusion Acute cerebral infarction with CMBs are influenced by age,hypertension,lacunar infarction and leu-koaraiosis.Thrombolysis in acute cerebral infarction with CMBs can not augment the incidence of hemorrhagic transformation.