未溶栓治疗老年脑梗死患者转化自发性出血的发病率及其危险因素

摘要

目的 研究未溶栓治疗的老年脑梗死患者转化自发性出血的发病率及其危险因素.方法 选取2015年9月至2017年1月于新乡市中心医院行未溶栓治疗的急性脑梗死患者146 例,根据有无发生自发性出血将其分为未出血组与出血组.比较两组患者各项指标并行单因素分析,比较两组预后.结果 根据Logistic回归性分析,将脑梗死后转化为自发性出血作为因变量,将其他因素作为自变量,筛选出4个危险因素:心房颤动、脑白质病史、抗凝治疗和大面积脑梗死.出血组显效率和总有效率(71. 11%、86. 67%)高于未出血组(37. 35%, 69. 88%,P＜0. 05).结论 心房颤动、脑白质病史、抗凝治疗和大面积脑梗死是未溶栓治疗的老年脑梗死患者转化自发性出血的危险因素,需引起警惕.%Objective To study the incidence and risk factors of spontaneous intracerebral hem-orrhage in elderly patients with cerebral infarction treated by thrombolytic therapy.Methods A total of 146 patients with acute cerebral infarction treated by thrombolytic therapy in Xinxiang Central Hospital from September 2015 to January 2017 were divided into non bleeding group and hemorrhage group ac-cording to with spontaneous hemorrhage or not.Clinical indicators of the two groups were compared and analyzed single factor analysis,and the prognoses of the two groups were compared.Results According to Logistic by univariate analysis,with cerebral infarction converted into spontaneous bleeding as the de-pendent variable and the other factors as the independent variables,four risk factors were determined as risk factors:atrial fibrillation,history of cerebral white matter,anticoagulant therapy and large area of cerebral infarction.Markedly effective rate and total effective rate in the bleeding group (71. 11%, 86. 67%)were significantly higher than those in non bleeding group (37. 35 ,69. 88%),the difference was statistically significant (P＜0. 05 ).Conclusions Atrial fibrillation,history of cerebral white mat-ter,anticoagulation and large area of cerebral infarction are the risk factors of the conversion into sponta-neous bleeding in elderly patients with cerebral infarction,which needs to be alerted.