CAJ | 학술논문

目的探讨影响脑梗死后自发性出血性转化的危险因素. 方法对四川省人民医院神经内科自2011年11月至2012年2月收治的151例未溶栓治疗的脑梗死患者进行连续性登记研究,根据住院期间CT或MRI复查示有无颅内出血分为出血组16例和非出血组135例.对可能影响自发性出血性转化的因素进行Logistic回归分析,并对校正后的独立危险因素进行受试者工作曲线(ROC)分析以获得最佳预测自发性出血性转化的值. 结果单因素分析显示出血组患者入院时随机血糖、脉压差、超敏C反应蛋白水平与非出血组比较差异有统计学意义(P＜0.05).多因素Logistic回归分析结果表明入院时随机血糖(OR=1.274,95％CI:1.093～1.485)、脉压差(OR=1.208,95％CI:1.005～1.051)是影响自发性出血性转化的独立危险因素.ROC曲线分析显示,入院时随机血糖为5.575 mmol/L、脉压差为35 mm Hg时具有最佳预测效应. 结论入院时随机血糖升高、脉压差增高的患者需高度警惕自发性出血性转化的可能.
목적 탐토영향뇌경사후자발성출혈성전화적위험인소. 방법 대사천성인민의원신경내과자2011년11월지2012년2월수치적151례미용전치료적뇌경사환자진행련속성등기연구,근거주원기간CT혹MRI복사시유무로내출혈분위출혈조16례화비출혈조135례.대가능영향자발성출혈성전화적인소진행Logistic회귀분석,병대교정후적독립위험인소진행수시자공작곡선(ROC)분석이획득최가예측자발성출혈성전화적치. 결과 단인소분석현시출혈조환자입원시수궤혈당、맥압차、초민C반응단백수평여비출혈조비교차이유통계학의의(P＜0.05).다인소Logistic회귀분석결과표명입원시수궤혈당(OR=1.274,95％CI:1.093～1.485)、맥압차(OR=1.208,95％CI:1.005～1.051)시영향자발성출혈성전화적독립위험인소.ROC곡선분석현시,입원시수궤혈당위5.575 mmol/L、맥압차위35 mm Hg시구유최가예측효응. 결론 입원시수궤혈당승고、맥압차증고적환자수고도경척자발성출혈성전화적가능.
Objective To investigate the risk factors of spontaneous hemorrhagic transformation after cerebral infarction.Methods The clinical and imaging data of 151 patients with cerebral infarction without thrombolytic therapy were analyzed retrospectively.According to the intracranial hemorrhage under hospital CT scan or MRI,these patients were divided into hemorrhagic transformation (HT) group (n=16) and non-HT group (n=135).Influencing factors were analyzed by stepwise logistic regression.The receiver operating characteristic (ROC) curve analysis on the independent risk factors was performed to obtain the optimum predictive value of spontaneous hemorrhagic transformation.Results Admission blood glucose,pulse pressure and high sensitivity C-reactive protein levels were statistically significant between HT and non-HT groups (P ＜0.05).Multivariate logistic regression analysis demonstrated that admission blood glucose (OR:1.274,95％CI:1.093-1.485),pulse pressure (OR:1.208,95％ CI:1.005-1.051) were independent predictors of spontaneous hemorrhagic transformation in ischemic stroke without thrombolytic therapy.The ROC curve showed that when random blood glucose after admission was 5.575 mmol/L and pulse pressure was 35 mm Hg,the optimum prediction effect could be achieved.Conclusion When an ischemic stroke patient has high levels of blood glucose and pulse pressure on admission,he should be alert the occurrence of HT.