溶栓后出血评分对尿激酶溶栓治疗后脑梗死患者出血转化的预测价值

目的探讨溶栓后出血评分(HAT评分)对尿激酶溶栓治疗后脑梗死患者出血转化(HT)的预测价值。方法选择我院神经内科2012—2013年收治的急性脑梗死患者136例,均采用尿激酶静脉溶栓治疗,进行HAT评分并依据评分结果分为0分组、1分组、2分组、3分组和≥4分组,比较各组HT情况。结果本组136例患者共17例发生HT,其中13例为出血性梗死(HI)、4例为脑实质内血肿(PH),各组HT发生率比较,差异有统计学意义(χ2=57.54,P0.01);Spearman等级相关分析结果显示,HAT评分与HT发生率呈正相关(r=0.422,P0.001)。结论 HAT评分较高(≥3分)的脑梗死患者静脉溶栓治疗出血风险较大,应慎重选择治疗方案。

HAT Score for Predicting Hemorrhagic Transformation in Brain Infarction Patients Treated with Urokinase

Objective To evaluate the value of HAT score for predicting hemorrhagic transformation in brain infarction patients treated with urokinase. Methods A total of 136 patients with brain infarction were selected in Neurology Department of our hospital from 2012 to 2013. All patients treated with intravenous urokinase,evaluated by HAT score,and then divided into groups 0,1,2,3 and 4 according to HAT score. Incidence of hemorrhagic transformation was compared in each group. Results In the 136 patients,17 patients occurred hemorrhagic transformation,thereinto 13 occurred hemorrhagic infarction,4 oc-curred parenchyma haematoma. There was significant difference of the incidence of hemorrhagic transformation in each group（χ2=57. 54,P﹤0. 01）. Spearman correlation analysis showed that,HAT score was positively correlated with the incidence of hemorrhagic transformation（r=0. 422,P﹤0. 001）. Conclusion Brain infarction patients with higher HAT score（≥3）has a great bleeding risk,and the choice of intravenous thrombolysis should be cautiously make.