摘要
目的研究老年脑梗死患者静脉溶栓后出血性转化的危险因素。方法选择行静脉溶栓治疗的老年脑梗死患者290例,按照静脉溶栓后是否出现出血性转化分为出血性转化组(n=56)与非出血性转化组(n=234),比较两组患者的基本资料及血清25羟维生素D(25 hydroxyvitamin D,25OHD)的变化,采用单因素分析及Logistic回归模型分析出血性转化的危险因素。结果两组患者在年龄、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、Fazekas分级、血清25OHD、血清钙、应激性血糖升高比值(stress hyperglycemia ratio,SHR)方面比较,差异有统计学意义(P<0.05);多因素分析结果,NIHSS评分>9分、Fazekas分级、血清25OHD>18μg/L、血清钙≥2.25mmol/L及SHR>1.18是老年脑梗死患者静脉溶栓后出血性转化的独立影响因素(P<0.05)。结论识别老年脑梗死患者静脉溶栓后出血性转化的危险因素,对预防静脉溶栓后出血性转化具有重要价值。
Objective To analyze the risk factors of hemorrhagic transformation after intravenous thrombolysis in elderly patients with cerebral infarction.Methods A total of 290 elderly patients with cerebral infarction who were selected for intravenous thrombolysis,according to whether hemorrhagic transformation occurs after intravenous thrombolysis diuide into hemorrhagic transformation group and non hemorrhagic transformation the basic clinical data and laboratory indicators such as serum 25-hydroxyvitamin D 25OHD were collected from the two groups,univariate analysis and Logistic regression model were used to analyze the risk factors of hemorrhagic transformation.Results There were statistically significant differences in age,National Institutes of Health Stroke Scale(NIHSS)score,Fazekas classification,serum 25OHD,serum calcium,and stress hyperglycemia ratio(SHR)between the two groups of patients(P<0.05).The results of multivariate analysis showed that:NIHSS score>9 points,Fazekas grade,serum 25OHD>18μg/L,serum calcium≥2.25mmol/L and SHR>1.18 were the hemorrhagic transformation after intravenous thrombolysis in elderly patients with cerebral infarction independent influencing factors(P<0.05).Conclusion Identifying the risk factors of hemorrhagic transformation after intravenous thrombolysis in elderly patients with cerebral infarction and establishing a predictive model is of great value in preventing hemorrhagic transformation after intravenous thrombolysis.
作者
范建平
曾俊
厉娜
FAN Jianping;ZENG Jun;LI Na(Department of Internal Medicine,Jinhua Rehabilitation Hospital,Zhejiang,Jinhua 321000,China;Department of Neurology,the Central Hospital of Jinhua,Zhejiang,Jinhua 321000,China)
出处
《中国现代医生》
2022年第36期63-66,70,共5页
China Modern Doctor
关键词
老年人
脑梗死
静脉溶栓
出血性转化
Elderly
Cerebral infarction
Intravenous thrombolysis
Hemorrhagic transformation
