急性脑梗死后出血转化的危险因素分析

目的 探讨急性脑梗死后出血转化的相关危险因素。方法 选取2016年12月-2017年12月入住本院的140例急性脑梗死患者,其中急性脑梗死后出现出血转化者70例,其余为无出血转化者70例,分析2组患者在入院时首次空腹血糖、总胆固醇、同型半胱氨酸、尿酸水平、高血压病病史、糖尿病病史、房颤病史、饮酒史及既往脑卒中病史的差异,先进行单因素分析,对差异有统计学意义的指标进一步行多因素Logistic回归分析。结果 急性脑梗死后出血转化组患者在入院时首次空腹血糖水平、心房颤动病史、高血压病史的例数均高于非出血转化组(P<0.05),而非出血转化组中总胆固醇水平高于出血转化组(P<0.05),2组同型半胱氨酸、尿酸水平、糖尿病病史、饮酒史、既往脑卒中病史无统计学差异(P>0.05)。结论 急性脑梗死患者入院时高空腹血糖水平(>6.1 mmol/l)、房颤病史、高血压病史是急性脑梗死发生出血转化的独立危险因素,而总胆固醇(TC)是防止出血转化的一个保护因素。

The analysis of risk factors for hemorrhagic transformation after acute cerebral infarction

ObjectiveTo investigate the risk factors for hemorrhagic transformation after acute cerebral infarction.Methods From december 2016 to december 2017,the clinicial data of 140 patients with acute cerebral infarction was collected as the research object. They were divided into HT group(n=70)and non-HT group(n=70)according to whether they had the HT or not.For all of the patients, the first fasting blood glucose,total cholesterol,homocysteine,Uric acid and the history of hypertension,diabetes,atrial fibrillation,and the history of drinking and the stroke were analysed.the univariate analysis was conducted to all, and the multivariate analysis was performed with the statistically significant variables by Cox regression model.Results Univariate analysis showed that in the hemorrhagic transformation group,the first fasting blood glucose,the history of atrial fibrillation and hypertension were higher than those in the non-hemorrhagic transformation group(P<0.05),while the total cholesterol was lower than that in the non-hemorrhagic transformation group(P<0.05). There were no statistical differences in the homocysteine,Uric acid and the history of diabetes, drinking and the stroke between two groups(P>0.05).Conclusion The first fasting blood glucose,the history of atrial fibrillation and hypertension were the risk factors for hemorrhagic transformation after acute cerebral infarction,while the total cholesterol was the protective factor to prevent the hemorrhagic transformation after acute cerebral infarction. Timely intervention of relevant risk factors could help the neurologist to improve the prognosis of patients with acute cerebral infarction.