| 急性前循环缺血性脑卒中取栓术后发生出血转化的影响因素 |
| 投稿时间：2024-10-18 修订日期：2024-11-25 点此下载全文 |
| 引用本文：杨志超,黄正千,孙勇.急性前循环缺血性脑卒中取栓术后发生出血转化的影响因素[J].医学研究杂志,2025,54(4):146-150 |
| DOI：
10.11969/j.issn.1673-548X.2025.04.026 |
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| 基金项目:江苏省连云港市老龄健康科研项目(L202301) |
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| 中文摘要:目的 探讨连云港市第一人民医院前循环急性缺血性脑卒中(acute ischemic stroke, AIS)患者取栓治疗(mechanical thrombectomy, MT)后发生出血转化(hemorrhagic transformation, HT)的影响因素。方法 回顾性收集2019年1月～2023年12月在徐州医科大学附属连云港医院神经介入科行取栓治疗的前循环急性缺血性脑卒中患者354例。根据术后24～72h复查的头颅CT结果进行分组,发生出血转化的患者为出血组,共208例,无出血转化的患者为对照组,共104例,比较两组之间的临床资料差异。计量资料分析采用Mann-Whitney U检验,计数资料分析采用χ2检验,使用多因素Logistic回归分析筛选影响因素。结果 相较于对照组的患者,出血组患者年龄偏大,既往存在心房颤动病史的比例较高、术前NIHSS评分较高、血小板计数较低、糖化血红蛋白较高、术前溶栓治疗的比例较高(P＜0.05)。多因素Logistic回归分析显示,血红蛋白(OR=1.02,95% CI:1.01～1.03, P=0.006),糖化血红蛋白(OR=1.24,95% CI:1.09～1.40, P＜0.001)是术后发生出血转化的危险因素。血小板计数(OR=0.99,95% CI:0.99～0.99, P=0.014)是术后发生出血转化的保护因素。结论 术前的血红蛋白、糖化血红蛋白、血小板计数均与MT后发生HT有关。 |
| 中文关键词:缺血性脑卒中 取栓 出血转化 影响因素 |
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| Influence Factors of Hemorrhagic Transformation after Mechanical Thrombectomy in Acute Anterior Circulation Ischemic Stroke. |
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| Abstract:Objective To explore the influence factors of hemorrhagic transformation in the First People′s Hospital of Lianyungang in patients with acute anterior circulation ischemic stroke (AIS) after mechanical thrombectomy (MT). Methods We collected the clinical data of 354 AIS patients who underwent MT in the Affiliated Lianyungang Hospital of Xuzhou Medical University from January 2019 to December 2023. They were grouped according to the results of cranial CT reviewed in 24-72h after the MT, and the patients who underwent HT were the HT group, with a total of 208 patients, and the patients who did not have HT were the control group, with a total of 104 patients. The clinical differences between the two groups were compared. Measurement data were analyzed using the Mann-Whitney U test, count data were analyzed using the χ2 test, and multivariate Logistic regression analysis was used to identify independent risk factors. Results Compared to control group, the patients of HT group were older, had a higher prevalence of atrial fibrillation, higher preoperative NIHSS scores, lower platelet counts, higher glycated hemoglobin levels, and a higher proportion of preoperative thrombolytic therapy (P < 0.05). Multivariate logistic regression analysis indicated that hemoglobin (OR = 1.02,95% CI:1.01-1.03, P = 0.006) and glycated hemoglobin (OR = 1.24,95% CI:1.09-1.40, P < 0.001) were independent influence factors for HT. Platelet count (OR = 0.99,95% CI:0.99-0.99, P = 0.014) was identified as a protective factor against HT. Conclusion Preoperative hemoglobin, glycated hemoglobin, and platelet count are all associated with HT following MT. |
| keywords:Acute ischemic stroke Mechanical thrombectomy Hemorrhagic transformation Influence factors |
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