Antithrombotic Drug Uses and Deep Intracerebral Hemorrhages in Stroke Patients With Deep Cerebral Microbleeds
Antithrombotic Drug Uses and Deep Intracerebral Hemorrhages in Stroke Patients With Deep Cerebral Microbleeds
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DOI：
10.1016/j.jstrokecerebrovasdis.2012.08.003
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发表时间：
2013-08-01
影响因子：
2.5
通讯作者：
Komatsu, Katsuya
中科院分区：
文献类型：
--
作者：
Imaizumi, Toshio;Inamura, Shigeru;Komatsu, Katsuya
背景资料：在脑微出血（MB）患者中，抗血小板或抗凝药物可增加脑出血（ICH）的发生率。为了研究抗血小板药物或华法林可能导致深部MB患者发生深部ICH的机制，我们前瞻性分析了807例因卒中入院的连续患者（351例女性和456例男性;平均年龄+/-标准差69.8 +/- 12.0岁）的深部ICH发生情况。研究方法：使用Kaplan-Meier方法生成无发生率曲线;使用对数秩检验比较深度ICH无发生率。随访期为0.5至71个月（平均值+/-标准差31.6 +/- 22.2个月）。结果如下：在深部MB患者中，与抗血小板药物相关的深部ICH发生率（1.0%/年; 180例患者中有6例ICH）并不显著高于未使用药物的患者（1.0%/年; 167例患者中有6例ICH; P = 0.977）。与未使用华法林相比，使用华法林相关的深部ICH的发生率并不显著增加。结论：多因素分析显示，抗血小板药物或华法林的使用对深部脑出血的发生没有显著影响。抗血小板药物或华法林并没有显著增加既存深部心肌梗死的卒中患者的深部ICH发生率。
Background: It has been suggested that antiplatelet or anticoagulant drugs elevate the rate of intracerebral hemorrhage (ICH) in patients with cerebral microbleeds (MBs). To investigate the mechanism by which antiplatelet drugs or warfarin may contribute to deep ICH occurrences in patients with deep MBs, we prospectively analyzed deep ICH occurrences in 807 consecutive patients (351 females and 456 males; mean age +/- standard deviation 69.8 +/- 12.0 years) who were admitted to our hospital with strokes. Methods: Occurrence-free rate curves were generated using the Kaplan-Meier method; deep ICH occurrence-free rates were compared using the log-rank test. The follow-up period was 0.5 to 71 months (mean +/- standard deviation 31.6 +/- 22.2 months). Results: In patients with deep MBs, the rates (1.0%/year; 6 ICHs in 180 patients) of deep ICH occurrence associated with antiplatelet drugs were not significantly greater than that without the drugs (1.0%/year; 6 ICHs in 167 patients; P = .977). The incidence of deep ICHs associated with warfarin use was not significantly greater than that without warfarin use. Conclusions: Multivariate analysis revealed that the use of antiplatelet drugs or warfarin did not significantly influence the occurrence of deep ICH in patients with deep MBs. Antiplatelet drugs or warfarin did not significantly elevate the rate of deep ICHs in stroke patients with pre-existing deep MBs.