[Analysis on the clinical characteristics and related risk factors of patients with hemorrhagic transformation after cerebral infarction].
[Analysis on the clinical characteristics and related risk factors of patients with hemorrhagic transformation after cerebral infarction].
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DOI：
10.3760/cma.j.issn.0254-6450.2012.11.018
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发表时间：
2012-11
影响因子：
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通讯作者：
Jiajun Chen;Shuang Zhang;Yunhua Zhao;X. Jin;Yuan-bing Li;Li-hong Huang
中科院分区：
文献类型：
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作者：
Jiajun Chen;Shuang Zhang;Yunhua Zhao;X. Jin;Yuan-bing Li;Li-hong Huang
目的分析总结脑梗死后出血性转化（HT）患者的临床特点及危险因素，为临床治疗和预防提供指导。方法回顾性分析2009 - 10/2012 - 03吉林大学中日联谊医院神经内科住院的HT患者49例，随机选择同期单纯急性脑梗死患者106例作为对照。患者的性别和年龄相当。收集了相关资料。数据处理采用SPSS17.0统计软件包。定性资料采用χ（2）检验，定量资料采用t检验。对各指标进行单因素分析，对有统计学意义的危险因素进行Logistic回归分析。结果（1）出血后临床症状加重21例，占HT组的42.9%，其中意识障碍加重8例，偏瘫加重7例。头痛、头晕5例。(2)发病后15天内梗死例数占87.0%。(3)皮质梗死、大面积梗死、心房颤动、脑栓塞、糖尿病、低密度脂蛋白胆固醇增高等HT相关因素增加脑梗死患者发生HT的危险性（P < 0.05）。最重要的因素是心房颤动和脑栓塞。(4)PH-2似乎比HT的其他亚型更不可能与临床症状联系起来。结论大动脉主干闭塞后的脑梗死易发生HT，尤以15天内发生者为多。短期预后与HT亚型有关，其危险因素有皮质梗死、大面积脑梗死、心房颤动、脑栓塞、糖尿病、高低密度脂蛋白胆固醇等。
OBJECTIVE To analyze and summarize the clinical characteristics and risk factors for patients with hemorrhagic transformation (HT) after cerebral infarction to provide guidance for its clinical treatment and prevention. METHODS In this study, data from 49 hospitalized patients with HT in the First Department of Neurology, China-Japan Union Hospital of Jilin University from October 2009 to March 2012, were reviewed retrospectively and 106 cases with acute cerebral infarction only during the same period, were chosen randomly as controls. Gender and age of the patients were comparable. Relevant information was collected. SPSS 17.0 statistical package was applied for data processing. Qualitative data were processed with χ(2) test, and measurable data was processed with t-test. Each index was analyzed with uni-variate analysis while statistically significant risk factors were included in the logistic review model to conduct the multivariate regression analysis. RESULTS (1) Clinical symptoms deteriorating after hemorrhage in 21 cases accounted for 42.9% of the HT group, among which the cases on degree of disturbance to consciousness had an aggravation in 8 cases and hemiplegia increase in another 7 cases. Headaches and dizziness were found in 5 cases. (2) Number of infarction within 15 days after the occurrence of HT accounted for 87.0%. (3) HT-related factors increased the risk of HT in cerebral infarction such as cortical infarction, large area of infarction, atrial fibrillation, cerebral embolism, diabetes and high level of low-density lipoprotein cholesterol (P < 0.05). The most important factors were atrial fibrillation and cerebral embolism. (4) PH-2 seemed more unlikely to link with clinical symptoms than other subtypes of HT. CONCLUSION Cerebral infarction after occlusion of the main artery trunk was prone to HT, especially when it appeared within 15 days. Short-term prognosis seemed to be related to the subtypes of HT, with risk factors as cortical infarct, massive cerebral infarction, atrial fibrillation, cerebral embolism, diabetes, high low-density lipoprotein cholesterol etc. on HT.