急性缺血性脑卒中血管内治疗后 症状性颅内出血的预测因素

目的 探讨急性缺血性脑卒中血管内治疗后症状性颅内出血的预测因素。方法 选取2014年1月-2017年12月因急性缺血性脑卒中至本院就诊并进行血管内治疗的患者,记录其一般情况与凝血功能,观察其治疗效果与不良反应,采用Logistic回归分析颅内出血的影响因素。结果 血管内治疗颅内出血概率为16.09%。发生颅内出血的患者平均年龄(64.46±15.47)岁,饮酒率28.57%,高血压患病率71.43%,糖尿病患病率42.86%,溶栓前抗血小板聚集药使用率64.26%,溶栓前NIHSS评分(15.63±6.84)分,溶栓前血小板计数(182.05±52.49)×10⁹/L,溶栓前INR(1.09±0.16),溶栓前收缩压(145.79±12.40)mmHg,均高于未出血组; 进一步logistic回归分析显示年龄OR=1.75(0.82～2.08),饮酒OR=0.99(0.47～1.65),高血压病OR=4.29(3.74～5.63),溶栓前NIHSS评分OR=2.81(1.46～3.26),溶栓前收缩压OR=1.45(1.15～1.93)为血管内治疗后颅内出血的危险因素(P<0.05)。结论 年龄、饮酒、高血压病、NIHSS评分溶栓前收缩压为血管内治疗颅内出血的危险因素。

The predictors of symptomatic intracranial hemorrhage after endovascular treatment of acute ischemic stroke

ObjectiveTo investigate the predictors of symptomatic intracranial hemorrhage after endovascular treatment of acute ischemic stroke.Methods From January 2014 to December 2017, the patients with acute ischemic stroke in our hospital and treated with intravascular therapy were selected. General condition and coagulation function were recorded, the effects and adverse reactions were observed, and the factors affecting the intracranial hemorrhage were investigated by Logistic regression.Results The probability of intracerebral hemorrhage was 16.09%. The average age of the patients with intracranial hemorrhage was(64.46±15.47)years, the drinking rate was 28.57%, the prevalence rate of hypertension was 71.43%, the prevalence rate of diabetes was 42.86%, the use rate of antithrombotic antithrombotic drugs before thrombolysis was 64.26%, the NIHSS score before thrombolysis was(15.63±6.84)score, the platelet count was(182.05±52.49)×10⁹/L, INR was(1.09±0.16)and systolic pressure was(145.79±12.40)mmHg, which were significantly higher in intracerebral hemorrhage group than those in non bleeding group. Further logistic regression analysis showed that age OR=1.75(0.82～2.08), drinking OR=0.99(0.47～1.65), hypertension OR=4.29(3.74～5.63), pre thrombolytic NIHSS score OR=1.81(1.46～3.26), and systolic pressure before thrombolysis OR=1.45(1.15～1.93)were risk factors for intracerebral hemorrhage(P<0.05).Conclusion Age, drinking, hypertension and NIHSS, systolic pressure before thrombolysis were risk factors for intracerebral hemorrhage.