大血管闭塞性脑梗死患者桥接治疗转化性出血的危险因素
陈坤成 占凌辉 谢 芳 陈星宇
厦门大学附属中山医院，福建 厦门 361004
通信作者：陈星宇
【摘要】 目的 分析桥接治疗大血管闭塞性脑梗死出血性转化的危险因素。方法 回顾性分析2018-01—2020-12 厦门大学附属中山医院收治的 73 例接受桥接治疗大血管闭塞性脑梗死患者的临床资料，根据治疗后患者是否出现转化性出血分为出血性组（21 例）和非出血性组（52 例）。比较 2 组患者性别、年龄、是否吸烟、是否合并高血压、是否合并糖尿病、是否合并房颤、是否合并高脂血症、血小板相关数值、肝肾功能、凝血功能、NIHSS 评分等指标，采取多因素 Logistic 回归分析大血管闭塞性脑梗死出血性转化的危险因素。结果 出血组患者年龄>70 岁（P=0.027）、血小板计数<185×109 个/L（P=0.029）、APTT> 30.3 s（P=0.014）、NIHSS 评分>18 分（P=0.015）是大血管闭塞性脑梗死转化性出血的危险因素。结论 年龄大、血小板计数低、APTT 时间延长、NIHSS 评分均可能会影响大血管闭塞性脑梗死的疗效，增加术后转化性出血的发生率，是大血管闭塞性脑梗死患者转化性出血的危险因素，应引起临床重视。
【关键词】 脑梗死；桥接治疗；大血管闭塞性；转化性出血；危险因素
【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1673-5110 （2022） 06-0759-04
基金项目：厦门市科技计划项目（编号：3502Z20209036）
DOI：10.12083/SYSJ.220609
Risk factors of hemorrhagic transformation in bridging therapy for large vessel occlusive cerebral infarction
CHEN Kuncheng，ZHAN Linghui，XIE Fang，CHEN Xingyu
Zhongshan Hospital Affiliated to Xiamen University，Xiamen 361004，China
Corresponding author：CHEN Xingyu
【Abstract】 Objective large vessel occlusive cerebral infarction. To analyze the risk factors of hemorrhagic transformation in bridging therapy for Methods The clinical data of 73 patients with large vessel occlusive cerebral infarction who received bridging therapy from January 2018 to December 2020 in Zhongshan Hospital Affiliated to Xiamen University were retrospectively analyzed. According to the number of cases，they were divided into hemorrhagic group（21 cases）and non-hemorrhagic group（52 cases）. Gender，age，smoking，hypertension，diabetes，atrial fibrillation，hyperlipidemia，platelet-related values，liver and kidney function，blood coagulation function，and baseline National Institutes of Health stroke scale（NIHSS）were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the risk factors of hemorrhagic transformation of large vessel occlusive cerebral infarction. Results Age>70 years，blood platelet<185×109 L-1 ，APTT>30.3 s，and NIHSS score>18 in the hemorrhagic group were risk factors for hemorrhagic transformation of large vessel occlusive cerebral infarction（P<0.05）. Conclusion Older age，low blood platelet，prolonged APTT time，and NIHSS score may affect the curative effect of large vessel occlusive cerebral infarction，increase the incidence of postoperative hemorrhagic transformation，and are the risk of hemorrhagic transformation in patients with large vessel occlusive cerebral infarction. Factors risk factors for hemorrhagic transformation should be paid attention to by clinicians.
【Key words】 Cerebral infarction；Bridging therapy；Large vessel occlusion；Hemorrhagic transformation； Risk factors
