摘要
目的研究不同亚型急性脑梗死后出血性转化（HT）的患病率及分型，并探讨其临床意义。方法选择南方医科大学附属南方医院及中山市人民医院神经内科2008～2011年收治的急性脑梗死患者977例，按TOAST分型分为：大动脉粥样硬化型（LAA）、心源性脑栓塞型（CE）、小动脉性闭塞型（SA0）、其他明确病因型（OC）和不明原因型（UND）。HT分为出血性梗死（HI）及脑实质内血肿（PH）两种类型。统计各亚型患者临床资料，比较LAA、CE、SAO、OC、UND脑梗死HT的患病率及HT类型的不同，并进行统计学分析。结果高血压在LAA的发生率最高，糖尿病在SAO最高，心房纤颤在CE中的发生率最高。高脂血症在不同亚型脑梗死中所占的比重无明显差异。LAA、CE、SAO、OC、UND脑梗死患者HT的患病率依次为12．8％、31．1％、6．6％、4．5％和5．5％，差异有统计学意义（x^2=61，P〈0．01）；不同亚型脑梗死HT分型不同，PH型多见于CE中（x^2=31，P〈0．01）。结论不同亚型急性脑梗死危险因素分布不同，HT患病率及分型不同，各亚型HT发生的差异与危险因素分布不同有关。
Objective To study the prevalence and subtype of hemorrhagic transformation（HT） among patients with different subtypes of acute cerebral infarction,and investigate its clinical significance. Methods 977 patients with acute cerebral infarction from January 2008 to December 2011 were divided into groups according to the stroke subtypes：large-artery atherosclerosis（LAA）, cardioembolism（CE）, small-artery occlusion （ SAO）, undetermined cause （ UND）, and other determined cause （OC）. HT included hemorrhagic infarction （HI） and parenchymal hematoma （PH）. The baseline data were registered and the prevalence and subtype of HT between different groups were compared. Results The rates of hypertension were the highest in LAA,The rate of diabetes was the highest in SAO,The rate of atrial fibrillation was the highest in CE. The rates of hyperlipidemia had no significant difference a- mong different subtypes of CI. The HT incidence of LAA, CE, SAO, OC, UND were 12.8%,31.1 %, 6.6%, 4.5 %, 5.5 % respec- tively,the difference was statistically significant （x^2= 61 ,P〈0.01）. As to the subtype of HT,PH was more common in CE group （x^2= 3t,P〈0.01）. Conclusion Distribution of risk factors, HT prevalence and classification are different in different subtypes of acute cerebral infarction, the differences might be related to the distribution of different risk factors. Key words., brain infarction; hemorrhagic transformation; prevalence
出处
《重庆医学》
CAS
CSCD
北大核心
2013年第31期3781-3783,共3页
Chongqing medicine
基金
广东省中山市科技局科技创新基金资助项目(2013ZA106)
关键词
脑梗死
出血性转化
患病率
brain infarction
hemorrhagic transformation
prevalence
