Risk Factors for Early Intracerebral Hemorrhage after Intravenous Thrombolysis with Alteplase.
Risk Factors for Early Intracerebral Hemorrhage after Intravenous Thrombolysis with Alteplase.
复制标题
阿替普酶静脉溶栓后早期脑出血的危险因素
DOI：
10.5551/jat.49783
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发表时间：
2020-11-01
影响因子：
4.4
通讯作者：
Han Z
中科院分区：
文献类型：
--
作者：
Lin X;Cao Y;Yan J;Zhang Z;Ye Z;Huang X;Cheng Z;Han Z
目的：脑出血(ICH)是溶栓治疗最严重的并发症之一。有症状的脑出血与不良后果有关。据报道，症状性脑出血最常发生在静脉溶栓后的最初几个小时内。我们的目的是确定溶栓后早期(12小时内)脑出血的危险因素。方法：对2008年3月/2017年11月在温州医科大学附属两所医院接受阿尔替普酶治疗的急性缺血性卒中患者进行分析。脑出血的诊断时间定义为从静脉注射阿尔替普酶到首次在CT上发现出血的时间。收集人口统计数据、病史、临床特征和实验室检查结果。对溶栓后早期(12h内)脑出血的预测因素进行单因素分析和多因素Logistic回归分析。结果：197例患者溶栓后早期(12h内)脑出血13例(6.6%)。单因素分析显示，早期脑出血患者与既往卒中史显著相关(P=0.04)。在调整多因素分析中的潜在混杂因素后，既往卒中史(优势比[OR]：5.752，95%可信区间[CI]：1.487-22.248；P=0.011)和房颤(OR：5.428，95%可信区间：1.427-20.640；P=0.013)与早期脑出血有关。结论：既往卒中和心房颤动是阿尔替普酶静脉溶栓后早期(12h内)脑出血的独立危险因素。
Aim: Intracerebral hemorrhage (ICH) is one of the most severe complications of thrombolysis. Symptomatic ICHs are associated with adverse outcomes. It has been reported that symptomatic ICHs most commonly occur within the first few hours after the initiation of intravenous thrombolysis. Our aim here was to determine the risk factors for early ICH (within 12 h) after thrombolysis. Methods: We analyzed patients with acute ischemic stroke who received intravenous alteplase at two hospitals affiliated to Wenzhou Medical University between March 2008 and November 2017. The ICH diagnosis time was defined as the time from the intravenous administration of alteplase to the first detection of hemorrhage on computed tomography. Demographic data, medical history, clinical features, and laboratory examination results were collected. Univariate analysis followed by multivariable logistic regression analysis was performed to determine the predictors of early ICH (within 12 h) after thrombolysis. Results: Among 197 patients, early ICH (within 12 h) after thrombolysis occurred in 13 patients (6.6%). In the univariate analysis, patients with early ICHs were significantly correlated with prior stroke (P = 0.04). After adjusting for potential confounders in the multivariate analysis, prior stroke (odds ratio [OR]: 5.752, 95% confidence interval [CI]: 1.487–22.248; P = 0.011) and atrial fibrillation (OR: 5.428, 95% CI: 1.427–20.640; P = 0.013) were associated with early ICH. Conclusions: Prior stroke and atrial fibrillation are independent risk factors for early ICHs (within 12 h) after intravenous thrombolysis with alteplase.
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影响因子：
29
作者：
Yaghi S;Boehme AK;Dibu J;Leon Guerrero CR;Ali S;Martin-Schild S;Sands KA;Noorian AR;Blum CA;Chaudhary S;Schwamm LH;Liebeskind DS;Marshall RS;Willey JZ
通讯作者：
Willey JZ
影响因子：
29
作者：
Yaghi S;Eisenberger A;Willey JZ
通讯作者：
Willey JZ
影响因子：
8.3
作者：
Gumbinger, Christoph;Gruschka, Philipp;Ringleb, Peter
通讯作者：
Ringleb, Peter
DOI：
10.1016/j.jstrokecerebrovasdis.2011.05.006
发表时间：
2012-11-01
影响因子：
2.5
作者：
Mokin, Maxim;Kass-Hout, Tareq;Mehta, Bijal
通讯作者：
Mehta, Bijal
影响因子：
8.3
作者：
VANSWIETEN, JC;KOUDSTAAL, PJ;VANGIJN, J
通讯作者：
VANGIJN, J