摘要
目的探讨静脉溶栓治疗急性脑梗死合并脑微出血的出血性转化的预后情况。方法收集2012年2月至2015年2月我院收治的86例合并脑微出血的急性脑梗死患者,随机分为研究组和对照组各43例。对照组采用安慰剂治疗,研究组采用静脉溶栓治疗,随访3个月。使用美国国立卫生院卒中量表(NIHSS)评价神经功能缺损情况,修正Rankin量表评价长期预后。综合比较两组患者出血性转化率、病死率、治疗3个月m RS评分及治疗前后NIHSS评分情况。结果研究组患者出血性转化率为20.9%,高于对照组的2.3%,差异具有统计学意义(P<0.05);研究组病死率与对照组比较差异无统计学意义(9.3%vs 7.0%,P>0.05)。研究组治疗后24 h、14 d的NIHSS评分以及治疗3个月后的m RS评分均低于对照组,差异具有统计学意义(P<0.05)。结论静脉溶栓治疗合并脑微出血的急性脑梗死会增加出血性转化风险,可有效改善神经功能缺损及远期预后,不增加总体病死率,值得临床推广使用。
Objective To study the prognosis of intravenous thrombolytic therapy on hemorrhagic transformation of acute cerebral infarction combined with cerebral microbleeds. Methods 86 cases of patients with acute cerebral infarction combined with cerebral microbleeds admitted to our hospital from February 2012 to February 2015 were selected and randomly divided into research group and control group, with 43 cases in each group. The control group was treated with placebo, the research group was treated with intravenous thrombolysis. All patients were followed up for 3 months. The nerve function defect was evaluated by US national institutes of health stroke scale （NIHSS）, the long-term prognosis was evaluated by modified Rankin scale. The hemorrhagic transformation rate, mortality, mRS score 3 months after treatment, NIHSS score before and after the treatment were compared between two groups. Results The hemorrhagic transformation rate of research group was 20.9%, higher than 2.3%of control group, with statistical difference （P〈0.05）;the mortality of two groups had no statistical difference （9.3%vs 7.0%, P〉0.05）. The NIHSS score after 24 h, 14 d of the treatment and mRS score after 3 months of the treatment in research group were lower than those of control group, with statistically significant difference （P 〈0.05）. Conclusions Intravenous thrombolysis in the treatment of acute cerebral infarction combined with cerebral microbleeds will increase the risk of hemorrhagic transformation, but can effectively improve the nerve function defect and long-term prognosis, without increasing total mortality, which is worthy of clinical promotion.
出处
《临床医学工程》
2015年第10期1347-1348,共2页
Clinical Medicine & Engineering
关键词
静脉溶栓
脑微出血
急性脑梗死
出血性转化
Intravenous thrombolysis
Cerebral microbleeds
Acute cerebral infarction
Hemorrhagic transformation
