脑梗死出血性转化的多层螺旋CT表现及相关危险因素分析

目的分析脑梗死出血性转化的多层螺旋CT表现及相关危险因素。方法选取2013年1月至2014年11月我院收治的脑梗死患者80例为研究对象,发病1-2d均行头颅CT平扫,发生出血性转化者纳入研究组(n=40),未发生出血性转化者纳入对照组(n=40),观察脑梗死出血性转化的多层螺旋CT检查结果、分型、表现,评价多层螺旋CT及增强CT扫描对其诊断灵敏度、特异度及准确度,采用单因素分析和多因素Logistic回归分析脑梗死出血性转化的相关危险因素。结果增强CT扫描显示HT为大片低密度灶内的点状、斑块状、条状、团状、散在不规则状高密度灶,密度不均匀,边缘不甚清晰,分为边缘型、中心型、混合型三种类型;增强CT诊断HT的灵敏度71.43%、准确度72.50%明显高于多层螺旋CT 54.29%、50.00%(P0.05),但特异度80.00%、20.00%比较无显著差异(P0.05);单因素分析显示研究组年龄大于60岁比例高于对照组,观察组SBP、DBP、血糖、NIHSS评分较对照组高,差异有统计学意义(P0.050);多因素Logistic回归分析结果显示脑梗死面积、血糖水平、NIHSS评分、CT低密度改变是导致脑梗死发生出血性转化的独立危险因素。结论增强CT扫描可提高对脑梗死出血性转化的诊断效能,此外脑梗死面积、血糖水平、NIHSS评分、CT低密度改变等是其独立危险因素,临床应予以重视。

Analysis on Multi Slice Spiral CT Features and Related Risk Factors of Hemorrhagic Transformation after Cerebral Infarction

Objective To analyze multi slice spiral CT features and related risk factors of hemorrhagic transformation after cerebral infarction.Methods 80 patients with cerebral infarction treated in our hospital from January 2013 to November 2014 were selected as the research objects,patients underwent brain CT scan on onset 1-2d,patients with hemorrhagic transformation were included in study group (n=40),patients without hemorrhagic transformation were included in the control group (n=40),multi slice spiral CT inspection results of hemorrhagic transformation after cerebral infarction,classification and performance were observed,diagnostic sensitivity,specificity and accuracy of multi slice spiral CT and enhanced CT scanning were esrimated,related risk factors of hemorrhagic transformation after cerebral infarction were single factor analyzed and multiple factor Logistic regression analyzed.Results Enhanced CT scan showed HT were large low density range punctiform,en plaque,strip,lumpy,scattered irregular shape high density range with uneven density,edge was not very clear,which were divided into peripheral type,central type,mixed type;sensitivity of enhanced CT in the diagnosis of HT 71.43％,accuracy 72.50％ were significantly higher than multi slice spiral CT (54.29％,50.00％) (P＜0.05),but there was no significant difference in specificity (80.00％,20.00％)(P＞0.05),single factor analysis showed that proportion of patients older than 60 years old in study group was significantly higher than control group,SBP,DBP,blood sugar,NIHSS scores in observation group were significantly higher than control group (P＜0.05);multiple factor Logistic regression analysis showed that area of cerebral infarction,blood sugar level,NIHSS scores,CT low density change were independent risk factors of occurrence of hemorrhagic transformation after cerebral infarction.ConclusionEnhanced CT scan can improve diagnostic efficacy to hemorrhagic transformation after cerebral infarction,blood sugar level,NIHSS scores,CT low density change are independent risk factors,it should be paid attention.