抗栓治疗与脑微出血及缺血性脑卒中后出血转化的关系.docVIP

抗栓治疗与脑微出血及缺血性脑卒中后出血转化的关系 王伟 聊城市第三人民医院 山东 聊城 252000 目的 探讨抗栓治疗与CMBs及缺血性脑卒中后脑出血转化(HT) 的关系?方法 选择1 2 7例急性缺血性脑卒中患者，入院3天内均行SWI序列检 查，将患者分为CMBs阳性组和阴性组，记录CMBs发生例数、病灶部位、数目，记 录患者的性别及年龄、病史及口服抗栓药物情况?所有患者入院后根据个体化原 则予以抗血小板或抗凝治疗.治疗后2周复查SWI及CT.观察两组患者CMBs的总 数、部位有无变化，有无HT.结果 抗栓治疗与CMBs的发生无明显相关(P 0?0 )，合并CMBs的抗血小板治疗患者(1 0?4 %)与抗凝治疗患者(1 4 . 3 %湘 比差异无显著性依chi;2 = 0. 3 2 4,P= 0. 5 6 9 ).抗栓治疗2周后CMBs阳 性组的CMB部位、总数与入院时比较差异无统计学意义(P 0?0 5 ),CMBs阴 性组未发现新的CMBs.CMBs阳性组发生HT 3例(8.82 %),CMBs阳性组发生 HT 8例(8 . 6 0 %)，两组比较差异无统计学意义(chi; 2 = 0 . 0 0 2 ,P= 0.9 9).结论 抗栓治疗与CMBs的发牛及HT无关. 关键词 脑微出血；缺血 性脑卒中；出血转化；抗栓治疗[Abstract] ObjectivTostudytherelatio nshipaboutthea ntithrombotictherapywithcerebralmicroble edsandpost — ischemicstrokehemorrhagictransforGmation(HT). MethodsToselect 1 2 7 casesofacuteischemicstrokepatients’SWIsequencewasperformedwithin 3 daysafteradmission,thepatie ntsweredividedi ntoCMBspositivegroupa ndn egati vegroup ? ThenumberofCMBs,thelocationandnumberoflesionswererecorded. Thesexandage ofpatientsandthehistoryofthepatientsandtheoraldrugresistancewererecorded. After admission,allpatientsweretreatedwithantiplateletoranticoagulanttherapyaccordingto theprincipleofindividualization? 2 weeksaftertreatment,SWIandCT werereviewed. ThetotalnumberandlocationofCMBsandwhetherornotHTinthetwogr oupswereobserved? ResultsAntithrombotictherapyandtheincidenceofCMBShadnosi gnificantlycorrelated(P 0 . 0 5 ). Therewasnosigrdficantdifferenceintheantiplatelettherapypatients( 1 0 . 4 %)andanticoagulationtherapypatients( 14. 3 %)(chi; 2 = 0. 3 2 4 ,P = 0. 5 6 9 ). TherewasnosigrdficantdifferenceinthenumG berofCMBsitesandthetotalnumberofCMBspositivegroup(P 0 ? 0 5 )after 2 weeksoftreatment,andthenewCMBswasnotfoundinCMBsnegativegroup? IntheCMBS positivegroup, 3 caseswereHT( 8 . 8 2 %),IntheCMBSpositivegroup, 8 caseswereoccurred( 8 . 6 0 %). Thedifferencebetweenthetwogroupswasnosta tKisetyicwalorsdigsn 讦icance(chi; 2 = 0. 0 0 2 ,P = 0 . 9 6 9 ). Conclusion Thea ntithrombotictherapyis no tassociatedwiththeoccurre nceofC