脑出血急性期合并脑梗死的危险因素分析

目的 探讨脑出血急性期合并脑梗死的危险因素。方法 按照发病后2周内弥散加权成像(diffusion weighted image,DWI)上是否有新的脑梗死灶将125例原发性脑出血患者分为2组,比较临床资料的差异。结果 21例DWI阳性者脑叶出血发生率、颅内大动脉狭窄发生率、平均血肿体积显著高于38例DWI阴性者(P<0.05)。Logistic回归分析显示入院第1 d平均动脉压降低幅度(OR=7.384,P<0.001)、脑叶出血(OR=3.124,P=0.021)及颅内大动脉狭窄(OR=5.044,P=0.027)与脑出血急性期合并新发脑梗死灶呈正相关。结论 平均动脉压降低幅度、脑叶出血、颅内大动脉狭窄可增加脑出血急性期合并急性脑梗死的风险。

The Risk Factor analysis of acute primary intracerebral haemorrhage with new ischemic brain lesions

ObjectiveTo explore the risk factors of acute primary intracerebral haemorrhage(pICH)with ischemic brain lesions.Methods 125 pICH patients were divided into two groups according to the presence of new ischemic lesions in diffusion weighted image(DWI)which was tested from patients within 2 weeks after onset.And the clinical data from two groups were compared.Results 21 positive patients with acute ischemic lesions had a higher rate of lobar pICH,intracranial artery stenosis and larger mean volume of hematoma than the 38 negative patients(P<0.05).As showed by regression,DWI lesions were positively associated with the presence of lobar ICH(OR=2.384,P=0.021),aggressive BP-lowering at the first day after admission(OR=3.124,P<0.001),and the presence of intracranial artery stenosis(OR=5.044,P=0.027).Conclusion Aggressive BP-lowering,lobar ICH,intracranial artery stenosis,and volume of hematoma would be the risk factors of pICH with ischemic brain lesions.