大面积脑梗死后出血性转化的危险因素分析

目的探讨大面积脑梗死患者急性期发生出血性转化的相关危险因素。方法回顾性分析102例大面积脑梗死患者的基本资料、治疗方法、生化指标等。按是否发生出血性转化分为出血性转化(HT)组25例和非出血性转化(NHT)组77例。对可能与HT相关的因素进行回归分析。结果 HT的发生率为24.51%;HT组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、纤维蛋白原低于NHT组,差异有统计学意义;HT组脂蛋白a(LPa)高于NHT组,差异有统计学意义。Logistic回归分析显示,TC(OR 2.350,95%CI 1.333～4.143)、LDL-C(OR 2.361,95%CI 1.347～4.138)、LPa(OR 0.965,95%CI 0.947～0.983)、纤维蛋白原(OR 2.397,95%CI 1.133～5.071)是发生出血性转化的独立危险因素(P<0.05)。结论 TC、LDL-C、LPa纤维蛋白原是大面积脑梗死发生出血性转化的独立危险因素。

Study on risk factors of hemorrhagic transformation in acute ischaemic stroke

Objective To evaluate factors that influences the occurrence of hemorrhagic transformation(HT)in patients with acute ischaemic stroke.Methods The general data and laboratory test results of 102 acute ischaemic stroke in-patients were analyzed retrospectively.The biochemical data and other risk factors were compared between acute ischaemic stroke patients with or without HT.Results Of these acute ischaemic stroke patients,25 had HT and 77 had no HT.Compared with non-HT group,TC,LDL-C and fibrinogen were significantly increased in HT group.However,the LPa was significantly higher than in non-HT group(P<0.05).Logistic regression analysis showed that TC(OR 2.350,95%CI 1.333~4.143),LDL-C(OR 2.361,95%CI 1.347~4.138),LPa(OR0.965,95%CI 0.947~0.983),fibrinogen(OR 2.397,95%CI 1.133~5.071)were independent risk factors of HT(P<0.05).Conclusion The lever of TC,LDL-C,LPa and fibrinogen are the major risk factors of HT in acute ischemic stroke.