摘要
目的探讨非瓣膜性心房颤动(NVAF)并发脑梗死出血转化(HT)的相关因素。方法分析中山大学孙逸仙纪念医院2011年1月至2016年11月286例NVAF并发脑梗死患者,有出血转化的31例,从255例无出血转化的患者中随机抽取124例组成病例组与对照组1:4的样本进行分析。对HT的因素进行Logistic回归分析。结果大面积脑梗死的患者更容易发生出血转化(OR=144.244,95%CI=6.175~3369.658,P=0.002),出现失语的患者也更容易发生出血转化(OR=6.020,95%CI=1.077~33.640,P=0.041)。而双侧脑梗死的患者发生出血转化的风险较低(OR=0.165,95%CI=0.028~0.973,P=0.047),女性患者相比男性患者发生出血转化的风险较低(OR=0.017,95%CI=0.002~0.164,P<0.001)。此外,尿酸较高的患者发生出血转化的风险较低(OR=0.988,95%CI=0.981~0.996,P=0.003)。结论大面积脑梗死、失语分别是NVAF并发HT的危险因素,而双侧脑梗死、女性、高尿酸患者是NVAF并发HT风险性低。
Objective To investigate the related factors of hemorrhagic transformation(HT)of non valvular atrial fibrillation(NVAF)complicated with cerebral infarction.Methods Retrospective analysis of 286 patients with NVAF complicated with cerebral infarction from January 2011 to November 2016 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University,There were 31 cases of HT.124 cases were randomly selected from 255 cases without HT,and set as cases group compared with cases of HT(control group).The Logistic regression analysis was performed to search the related factors of HT after cerebral infarction.Results The patients having larger area of cerebral infarction were more likely to have HT(OR=144.244,95%CI=6.175-3369.658,P=0.002).The patients having aphasia were also more likely to have HT(OR=6.020,95%CI=1.077-33.640,P=0.041).The patients having bilateral cerebral infarction had lower risk of HT(OR=86.132,95%CI=2.925-2536.316,P=0.010).Female patients also had lower risk of HT than male patients(OR=0.017,95%CI=0.002-0.164,P<0.001).For the patients of NVAF complicated with cerebral infarction,the higher uric acid level the lower risk of HT(OR=0.988,95%CI=0.981-0.996,P=0.003).Conclusion Large-scale cerebral infarction,aphasia were the risk factors of hemorrhagic cerebral infarction.Bilateral cerebral infarction,female,higher uric acid were a protective factor for hemorrhagic cerebral infarction respectively.
作者
黄惠琴
陈样新
李又佳
黄燕
Huang Huiqin;Chen Yangxin;Li Youjia;Huang Yan(Department of Neurology,the Zhaoqing First People`s Hospital,Guangdong 526000,China)
出处
《脑与神经疾病杂志》
2020年第8期485-489,共5页
Journal of Brain and Nervous Diseases
关键词
非瓣膜性心房颤动
脑梗死
出血转化
相关因素
Non-valvular atrial fibrillation
Cerebral infarction
Hemorrhage transformation
Relevant factors
