急性脑梗死非溶栓患者出血转化的影响因素分析

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摘要目的分析急性脑梗死非溶栓患者出血转化的影响因素。方法回顾性分析2017年1月～2018年12月于我院住院的802例急性脑梗死非溶栓患者的临床资料，按照是否发生出血转化将其分为出血转化组（35例）和非出血转化组（767例）。比较两组的相关因素，后将差异有统计学的因素进一步纳入多因素Logistic回归分析。结果单因素分析结果显示，两组患者的年龄、高血压病史、房颤、冠心病、心脏病、卒中类型、大面积脑梗死、美国国立卫生研究院卒中量表（NIHSS）评分、抗血小板药物、清蛋白水平比较，差异有统计学意义（P＜0.05）。多因素Logistic回归分析结果显示，高NIHSS评分、大面积脑梗死及低清蛋白水平均是出血转化发生的独立危险因素，高血压病史是独立保护因素（P＜0.05）。结论低清蛋白水平、大面积脑梗死、高NIHSS评分是急性脑梗死非溶栓患者出血转化的独立危险因素，高血压是其独立保护因素，这为临床决策上的制定提供了极大帮助，但仍需大样本的创新研究来进一步证实此结论。

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	刘明苏
	汤也
	付庆
	李光勤

关键词 ：清蛋白, 出血转化, 急性脑梗死, 非溶栓患者

Abstract：Objective To analyze the influencing factors of hemorrhage transformation in acute ischemic stroke patients without thrombolytic therapy.Methods Retrospective analysiswas performed in the clinical data of 802acute ischemic stroke patientswithout thrombolytic therapy from January 2017 to December 2018 in our hospital,and they were divided into hemorrhage transformation group(35cases)and non-hemorrhage transformation group(767 cases)according to whether hemorrhage transformation occurred or not.The related factors of the two groupswere compared,and the factorswith statistical differenceswere further included in themultivariate Logistic regression analysis.Results Univariate analysis results showed that there were statistically significant differences in age,history of hypertension,atrial fibrillation,coronary heart disease,heart disease,stroke type,large-area ischemic stroke,national institutes of health stroke scale(NIHSS)score,antiplatelet drugs,and albumin level between the two groups(P＜0.05).Multivariate Logistic regression analysis showed thathigh NIHSSscore,large-area ischemic stroke and low albumin levelwere independent risk factors for hemorrhagic transformation,and history ofhypertension was an independent protective factor for hemorrhagic transformation(P＜0.05).Conclusion Low albumin level,high NIHSS score,large-area ischemic stroke are independently risk factors for hemorrhagic transformation of acute ischemic stroke patients without thrombolytic therapy and hypertension is an independently protective factor,which has provided great help in clinical decision-making,but large sample of innovative researches are still needed to further confirm this conclusion.

Key words： Albumin Hemorrhagic transformation Acute ischemic stroke Without thrombolytic therapy

通讯作者: 李光勤，男，医学博士，主任医师，教授，硕士研究生导师，中国医师协会神经内科医师分会神经介入学组委员，重庆市神经病学专委会神经重症学组副组长及脑血管病学组委员，重庆市老年学学会心脑血管病专委会副主任委员，主要从事脑血管疾病、周围神经病及肌肉疾病研究，在国内外发表学术论文上百篇（其中SCI文章数10篇），参编学术专著8本（外文1本），参编教材1本

作者简介: 刘明苏（1992-），男，山东菏泽人，重庆医科大学2012级本硕连读七年制在读硕士研究生（2017年开始研究生阶段学习），2012～2013年于华中科技大学同济医学院联合培养1年，专业：神经病学，研究方向：脑血管疾病，已发表学术论文数10篇（第一作者SCI文章7篇）

引用本文:

刘明苏；汤也；付庆；李光勤. 急性脑梗死非溶栓患者出血转化的影响因素分析[J]. 中国当代医药, 2020, 27(17): 16-20.
LIU Ming-su； TANG Ye； FU Qing； LI Guang-qin. Analysis of influencing factors of hemorrhage transformation in acute ischem ic stroke patients without thrombolytic therapy. 中国当代医药, 2020, 27(17): 16-20.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I17/16

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