急性脑梗死患者阿替普酶静脉溶栓治疗致颅内出血的影响因素

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Abstract Objective To investigate the influential factors of intracranial hemorrhage (ICH) induced by Alteplase intravenous thrombolytic therapy in patients with acute cerebral infarction.Methods A retrospective analysis was performed on 44 cases of acute cerebral infarction treated with intravenous thrombolysis in the First Affiliated Hospital of Qiqihar Medical College from January 2021 to November 2022.Relevant clinical data of patients were collected.According to the presence or absence of ICH after intravenous thrombolytic therapy with Alteplase,patients were divided into ICH group and ICH free group,and the influencing factors of ICH after thrombolytic therapy were analyzed.Results Among the 44 patients,14 had ICH after intravenous thrombolytic therapy with Alteplase (31.8%).Gender,age,smoking,alcohol consumption,diabetes,past antithrombotic drugs,onset-to-needle time (ONT),TOAST classification,National Institutes of Health stroke scale (NIHSS) score before thrombolysis,baseline blood glucose level,incidence of elevated low-density lipoprotein cholesterol,and incidence of hyperhomocysteine were compared between patients in the ICH and non-ICH groups,and there were no statistical significances (P＞0.05).There were significant differences in the incidence of hypertension and previous ischemic stroke between the two groups (P＜0.05).Multivariate logistic regression analysis showed that age,ONT and history of ischemic stroke were independent influencing factors for ICH after Alteplase thrombolysis (P ＜0.05).Conclusion The use of Alteplase in acute cerebral infarction patients with ICH is related to age,hypertension,ONT,ischemic stroke history and many factors,clinical attention should be paid to patients with these risk factors,timely intervention.

Key words： Acute cerebral infarction Alteplase Intravenous thrombolysis Intracranial hemorrhage

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