实用医学杂志
實用醫學雜誌
실용의학잡지
THE JOURNAL OF PRACTICAL MEDICINE
2014年
6期
900-902
,共3页
脑梗死%脑微出血%静脉溶栓
腦梗死%腦微齣血%靜脈溶栓
뇌경사%뇌미출혈%정맥용전
Cerebral infarction%Cerebral microbleeds%Intravenous thrombolysis
目的：探讨急性脑梗死合并脑微出血（CMB）的患者在静脉溶栓后脑微出血的变化。方法：收集2011年1月1日至2012年12月31日在广州医学院第二附属医院神经内科住院的89例急性脑梗死患者，入院时均行常规 MRI 加梯度回波序列 T2加权检查，根据是否存在 CMB 分为有 CMB 组、无 CMB 组。记录两组患者的吸烟、饮酒、高血压、腔隙性脑梗死、糖尿病、白质疏松等既往史，并探讨CMB 的危险因素。患者经溶栓治疗后，观察CMB数目的变化。结果：经溶栓治疗后24 h复查，有CMB 组的CMB 个数与治疗前相比，轻度CMB 患者减少，重度CMB 患者增多；性别、年龄、高血压病、腔梗、白质疏松与 CMB 有显著相关性。结论：性别、年龄、高血压病、腔隙性脑梗死、白质疏松是急性脑梗死发生CMB的危险因素。急性脑梗死合并CMB患者溶栓治疗增加重度CMB的发生率，增加出血转化危险。
目的：探討急性腦梗死閤併腦微齣血（CMB）的患者在靜脈溶栓後腦微齣血的變化。方法：收集2011年1月1日至2012年12月31日在廣州醫學院第二附屬醫院神經內科住院的89例急性腦梗死患者，入院時均行常規 MRI 加梯度迴波序列 T2加權檢查，根據是否存在 CMB 分為有 CMB 組、無 CMB 組。記錄兩組患者的吸煙、飲酒、高血壓、腔隙性腦梗死、糖尿病、白質疏鬆等既往史，併探討CMB 的危險因素。患者經溶栓治療後，觀察CMB數目的變化。結果：經溶栓治療後24 h複查，有CMB 組的CMB 箇數與治療前相比，輕度CMB 患者減少，重度CMB 患者增多；性彆、年齡、高血壓病、腔梗、白質疏鬆與 CMB 有顯著相關性。結論：性彆、年齡、高血壓病、腔隙性腦梗死、白質疏鬆是急性腦梗死髮生CMB的危險因素。急性腦梗死閤併CMB患者溶栓治療增加重度CMB的髮生率，增加齣血轉化危險。
목적：탐토급성뇌경사합병뇌미출혈（CMB）적환자재정맥용전후뇌미출혈적변화。방법：수집2011년1월1일지2012년12월31일재엄주의학원제이부속의원신경내과주원적89례급성뇌경사환자，입원시균행상규 MRI 가제도회파서렬 T2가권검사，근거시부존재 CMB 분위유 CMB 조、무 CMB 조。기록량조환자적흡연、음주、고혈압、강극성뇌경사、당뇨병、백질소송등기왕사，병탐토CMB 적위험인소。환자경용전치료후，관찰CMB수목적변화。결과：경용전치료후24 h복사，유CMB 조적CMB 개수여치료전상비，경도CMB 환자감소，중도CMB 환자증다；성별、년령、고혈압병、강경、백질소송여 CMB 유현저상관성。결론：성별、년령、고혈압병、강극성뇌경사、백질소송시급성뇌경사발생CMB적위험인소。급성뇌경사합병CMB환자용전치료증가중도CMB적발생솔，증가출혈전화위험。
Objective To investigate the influence of intravenous thrombolysis to acute cerebral infarction with cerebral microbleeds (CMB). Methods Eight-nine patients with cerebral infarction in the Neurological Department of the Second Affiliated Hospital of Guangzhou Medical College from January 1st , 2011 to December 31st, 2012 were enrolled in this study. All patients were scanned with MRI and GRE. According to the presence of CMB, the patients were classified into two groups, including CMB group and non-CMB group. Past history of smoking, drinking, hypertension, lacunar infarction, diabetes and leukoaraiosis situation were recorded and risk factors of CMB were explored. All patients were treated with intravenous thrombolysis and rescanned with MRI to compare the total number of CMB 24 hours after thrombolysis. Results In the CMB group, the number of patients with mild CMB decreased and the number of patients with serious CMB increased after thrombolysis. CMB was associated with sex, age, hypertension, lacunar infarction and leukoaraiosis. Conclusions Sex, age, hypertension, lacunar infarction and leukoaraiosis were the risk factors of CMB in acute cerebral infarction. Thrombolysis in acute cerebral infarction augments the incidence of CMB and promotes the hemorrhagic transformation.
