摘要
目的:观察静脉溶栓治疗合并脑微出血的急性脑梗死后出血性转化的几率和预后情况,为临床安全应用溶栓疗法提供依据。方法:收集2002年1月至2011年12月在我院住院有完整静脉溶栓治疗资料的合并脑微出血急性脑梗死患者64例作为观察组,同时收集同期采用安慰剂治疗的64例患者作为对照组,比较两组发生出血性转换的比率、死亡率及治疗14 d后NIHSS及3个月的mRS评分情况。结果:观察组经溶栓治疗后有13例发生出血性转化,占20.3%,对照组有5例,占7.8%,两组比较有明显差异;观察组死亡5例,占7.8%,对照组4例,占6.3%,两组比较无明显差异;观察组14 d NIHSS评分4.2±3.7,明显优于对照组的评分7.9±4.1;治疗3个月mRS评分0～1分34例,占53.1%,明显高于对照组的22例(34.4%)。结论:静脉溶栓在合并脑微出血的急性脑梗死治疗中会增加出血性转化风险,但不增加总体的死亡率,可以有效地改善急性脑梗死近、远期预后,是安全有效的。
Objective To observe the hemorrhagic transformation rate and the prognosis of acute cerebral infarction combined with cerebral microbleeds after intravenous thrombolytic therapy. Methods 64 patients with acute cerebral infarction combined with cerebral microbleeds who received complete intravenous thrombolytic therapy from Jan. 2002 to Dec. 2011 were included as observation group, another 64 patients with the same diseases who received placebo were included as control group. The hemorrhagic conversion ratio, mortality, NIHSS after 14 days of treatment, and mRS score 3 months later of the two groups were compared. Results Hemorrhagic transformation was occurred in 13 （20.3%） patients in observation group after thrombolytic therapy, and was occurred in 5 patients （7.8%） in control group （P 〈 0.05）. 5 patients （7.8%） died in the observation group, while 4 patients （6.3%） in control group （P 〉 0.05）. The NIHSS after 14 days of treatment in observation group was significantly lower than that in control group （4.2 ± 3.7 vs. 7.9± 4.1 ） （P 〈 0.05）. There were 34 cases （53.1%） with the mRS score of 0-1 in observation group after 3 months of therapy, which there were 22 cases （34.4%） in control group （P 〈 0.05 ）. Conclusion Intravenous thrombolysis in the treatment for acute cerebral infarction combined with cerebral microbleeds would increase the risk of hemorrhagic transformation, but would not increase the overall mortality, and could effectively improve the short-term and long-term prognosis of acute cerebral infarction.
出处
《实用医学杂志》
CAS
北大核心
2013年第11期1785-1787,共3页
The Journal of Practical Medicine
关键词
脑出血
脑梗死
静脉溶栓
出血性转化
Cerebral hemorrhage
Brain infarction
Intravenous thrombolysis
Hemorrhagic transformation
