老年急性脑梗死患者脑白质疏松病变与静脉溶栓后出血转化关系研究.docVIP

老年急性脑梗死患者脑白质疏松病变与静脉溶栓后出血转化关系研究 　　[摘要] 目的 探讨老年急性脑梗死患者脑白质疏松病变程度与静脉溶栓后出血转化的关系。 方法 选取2014年7月～2016年1月本院收治的60岁以上符合静脉溶栓指征的老年急性脑梗死患者84例，依据ARWMC评分将患者分为轻度脑白质疏松、中度脑白质疏松和重度脑白质疏松，比较不同程度脑白质疏松患者溶栓后出血转化率。 结果 本研究中轻度脑白质疏松患者31例，中度脑白质疏松患者23例，重度脑白质疏松患者30例。重度脑白质疏松患者溶栓后出血转化率（26.67%）显著高于轻度脑白质疏松患者（6.45%）和中度脑白质疏松患者（4.35%），差异具有统计学意义（χ2=4.546，P=0.033；χ2=4.600，P=0.032）。 结论 老年急性脑梗死患者中，重度脑白质疏松患者采用溶栓治疗溶栓后出血转化率高，在临床上可将脑白质疏松程度作为老年急性脑梗死患者溶栓后发生出血转化的一个危险因素，据此而更好地指导我们的临床治疗。 　　[关键词] 急性脑梗死；脑白质疏松；静脉溶栓；出血转化 　　[中图分类号] R743.3 [文献标识码] A [文章编号] 2095-0616（2017）07-159-03 　　Study on relationship between leukoaraiosis lesions and hemorrhagic transformation after intravenous thrombolysis in elderly patients with acute cerebral infarction 　　ZHANG Jieyin GUAN Quansheng 　　Affiliated Hospital to Guangdong Medical University，Guangzhou 524001， China 　　[Abstract] Objective To explore the relationship between the degree of leukoaraiosis lesions and hemorrhagic transformation after intravenous thrombolysis in the elderly patients with acute cerebral infarction. Methods 84 elderly patients aged over 60 who had acute cerebral infarction according with indications of intravenous thrombolysis and admitted to our hospital from July 2014 to January 2016 were selected.They were divided into mild leukoaraiosis，moderate leukoaraiosis and severe leukoaraiosis according to ARWMC score.Rates of hemorrhagic transformation of leukoaraiosis of different degrees were compared. Results In this study，there were 31 patients with mild leukoaraiosis，23 patients with moderate leukoaraiosis and 30 patients with severe leukoaraiosis.Rate of hemorrhagic transformation after thrombolysis of patients with severe leukoaraiosis was 26.67%，significantly higher than that of patients with mild leukoaraiosis 4.35% and that of patients with moderate leukoaraiosis.The difference was statistically significant（χ2=4.546，P=0.033；χ2=4.600，P=0.032）. Conclusion In elderly patients with acute cerebral infarction，rate of hemorrhagic transformation after thromb