急性脑梗死重组组织型纤溶酶原激活剂静脉溶栓后症状性颅内出血临床特点及预后

目的分析急性缺血性脑卒中重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗后症状性颅内出血(sICH)患者的临床特点及预后。方法收集22例rt-PA静脉溶栓治疗后出血转化出现的sICH患者临床资料,分析其临床特点及预后。结果22例患者中(男17例、女5例),既往抗血小板聚集药物服用史7例,脑卒中病史7例,高血压病史17例,心脏病10例,长期吸烟史9例。12例sICH在溶栓后6h内发生,4例伴有消化道大出血。12/22例患者1周内死亡;余10例中,8例1个月后生活不能自理,2例生活可自理。结论rt-PA静脉溶栓治疗后出现sICH临床症状重、预后差、病死率高。

The Clinical Characteristics and Prognosis of Symptomatic Intracranial Hemorrhage after Recombinant Tissue Plasminogen Activator Thrombolysis in Acute Ischemic Stroke

Aim To analyze the clinical characteristics and prognosis of symptomatic intracranial hemorrhage (sICH) after recombinant tissue plasminogen activator (rt-PA) thrombolysis in acute ischemic stroke.Methods The data of 22 patients with symptomatic intracranial hemorrhage after rt-PA intravenous thrombolytic therapy were collected to analyze the clinical characteristics and prognosis.Results There were 17 men in the 22 patients,7 cases with history of taking antiplatelet aggregation,7 cases with history of stroke,and 17 cases with history of hypertension,10 cases with history of heart disease and 9 cases with history of smoking.There were 12 cases occurred within 6 hours after thrombolysis,4 cases with gastrointestinal bleeding,12 patients died within 1 week,8 cases could not take care of themselves after 1 month,2 cases could live by themselves.Conclusion sICH clinical symptoms after intravenous thrombolytic therapy aggravated,and had a poor prognosis and high mortality rate.