国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2012年
8期
570-574
,共5页
陈泽谷%罗建光%韩向君%赖玉洁
陳澤穀%囉建光%韓嚮君%賴玉潔
진택곡%라건광%한향군%뢰옥길
卒中%脑缺血%脑出血%血栓溶解疗法%磁共振成像%尿激酶型纤维蛋白溶酶原激活物%危险因素
卒中%腦缺血%腦齣血%血栓溶解療法%磁共振成像%尿激酶型纖維蛋白溶酶原激活物%危險因素
졸중%뇌결혈%뇌출혈%혈전용해요법%자공진성상%뇨격매형섬유단백용매원격활물%위험인소
Stroke%Brain Ischemia%Cerebral Hemorrhage%Thrombolytic Therapy%Urokinase-Type Plasminogen Activator%Magnetic Resonance Imaging%Risk Factors
目的 探讨脑微出血(cerebral microbleed,CMB)与急性缺血性卒中患者尿激酶动脉溶栓后出血性转化(hemorrhage transformation,HT)的相关性.方法 纳入接受尿激酶动脉溶栓的急性脑梗死患者,术前行MRI常规序列、磁敏感加权成像(susceptibility-weighted imagin,SWI)和CT扫描,术后48 h内复查CT或MRI,根据是否出现HT将其分入HT组和非HT组.详细记录患者的人口统计学资料、血管危险因素和SWI序列显示的CMB数量并进行比较和分析.结果 共纳入62例接受尿激酶动脉溶栓的急性脑梗死患者,其中HT组22例,非HT组40例.单变量分析显示,HT组高血压(81.8％对57.5％；x2=3.125,P=0.048)、糖尿病(63.6％对40.0％;x2=4.019,P=0.042)、吸烟(72.7％对37.5％;x2=4.971,P=0.030)和存在CMB(x2=5.297,P=0.018)的患者比例显著高于非HT组.多变量logistic回归分析显示,高血压[优势比(odds ratio,OR) 1.51,95％可信区间(confidence interval,CI)1.102～2.954；P=0.028]、糖尿病(OR 1.48,95％ CI 1.09～2.825;P=0.039)和CMB(OR1.867,95％ CI 1.103 ～3.158；P=0.020)是急性缺血性卒中患者尿激酶动脉溶栓后发生HT的独立危险因素.结论 CMB是急性缺血性卒中患者尿激酶动脉溶栓后发生HT的独立危险因素之一.
目的 探討腦微齣血(cerebral microbleed,CMB)與急性缺血性卒中患者尿激酶動脈溶栓後齣血性轉化(hemorrhage transformation,HT)的相關性.方法 納入接受尿激酶動脈溶栓的急性腦梗死患者,術前行MRI常規序列、磁敏感加權成像(susceptibility-weighted imagin,SWI)和CT掃描,術後48 h內複查CT或MRI,根據是否齣現HT將其分入HT組和非HT組.詳細記錄患者的人口統計學資料、血管危險因素和SWI序列顯示的CMB數量併進行比較和分析.結果 共納入62例接受尿激酶動脈溶栓的急性腦梗死患者,其中HT組22例,非HT組40例.單變量分析顯示,HT組高血壓(81.8％對57.5％；x2=3.125,P=0.048)、糖尿病(63.6％對40.0％;x2=4.019,P=0.042)、吸煙(72.7％對37.5％;x2=4.971,P=0.030)和存在CMB(x2=5.297,P=0.018)的患者比例顯著高于非HT組.多變量logistic迴歸分析顯示,高血壓[優勢比(odds ratio,OR) 1.51,95％可信區間(confidence interval,CI)1.102～2.954；P=0.028]、糖尿病(OR 1.48,95％ CI 1.09～2.825;P=0.039)和CMB(OR1.867,95％ CI 1.103 ～3.158；P=0.020)是急性缺血性卒中患者尿激酶動脈溶栓後髮生HT的獨立危險因素.結論 CMB是急性缺血性卒中患者尿激酶動脈溶栓後髮生HT的獨立危險因素之一.
목적 탐토뇌미출혈(cerebral microbleed,CMB)여급성결혈성졸중환자뇨격매동맥용전후출혈성전화(hemorrhage transformation,HT)적상관성.방법 납입접수뇨격매동맥용전적급성뇌경사환자,술전행MRI상규서렬、자민감가권성상(susceptibility-weighted imagin,SWI)화CT소묘,술후48 h내복사CT혹MRI,근거시부출현HT장기분입HT조화비HT조.상세기록환자적인구통계학자료、혈관위험인소화SWI서렬현시적CMB수량병진행비교화분석.결과 공납입62례접수뇨격매동맥용전적급성뇌경사환자,기중HT조22례,비HT조40례.단변량분석현시,HT조고혈압(81.8％대57.5％；x2=3.125,P=0.048)、당뇨병(63.6％대40.0％;x2=4.019,P=0.042)、흡연(72.7％대37.5％;x2=4.971,P=0.030)화존재CMB(x2=5.297,P=0.018)적환자비례현저고우비HT조.다변량logistic회귀분석현시,고혈압[우세비(odds ratio,OR) 1.51,95％가신구간(confidence interval,CI)1.102～2.954；P=0.028]、당뇨병(OR 1.48,95％ CI 1.09～2.825;P=0.039)화CMB(OR1.867,95％ CI 1.103 ～3.158；P=0.020)시급성결혈성졸중환자뇨격매동맥용전후발생HT적독립위험인소.결론 CMB시급성결혈성졸중환자뇨격매동맥용전후발생HT적독립위험인소지일.
Objective To investigate the correlation between cerebral microbleed (CMB) and hemorrhage transformation (HT) after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.Methods The patients with acute cerebral infarction treated with intra-arterial urokinase were enrolled.They were divided into either an HT group or a non-HT goup according to whether they had HT or not.Conventional MRI sequences,susceptibility-weighted imaging (SWI),and CT scan were performed before procedure.CT or MRI was reexamined within 48 hours after procedure.The patients' demographic data,vascular risk factors,and the SWI sequences showed the numbers of CMB were documented in detail and they were compared and analyzed.Results A total of 62 patients were included,22 in HT group and 40 in non-HT group.Univariate analysis showed that the proportions of hypertension (81.8％ vs.57.5％ ; x2 =3.125,P =0.048),diabetes (63.6％ vs.40.0％ ; x2 =4.019,P =0.042),smoking (72.7％ vs.37.5％ ; x2 =4.971,P =0.030),and presence of CMB (x2 =5.297,P =0.018) of patients in the HT group were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that hypertension (odds ratio [OR]1.51,95％ confidence interval [CI]1.102-2.954; P =0.028),diabetes (OR 1.48,95％ CI 1.09-2.825; P =0.039),and CMB (OR 1.867,95％ CI 1.103-3.158; P =0.020) were the independent risk factors for HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.Conclusions CMB was one of the independent risk factors for occurring HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.
