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目的研究急性脑梗死合并脑微出血发生的相关危险因素,阐明急性脑梗死患者发生脑微出血的相关机制。方法选取2012年1月—2015年9月收治的680例脑梗死患者,对所有患者进行MRI的SE(自旋回波序列)、FSE(快速自旋回波序列)、FE(场回波序列)、GRE(梯度回波)扫描,调查影响急性脑梗死患者发生脑微出血的因素,对所有危险因素进行分类、总结、分级,使用χ~2检验和多元回归方法进行分析、统计。结果患者发生脑微出血因素包括:年龄、饮浓茶史、慢性阻塞性肺疾患史、腔隙性脑梗死、脑白质稀疏、高血压史、心力衰竭史、平均动脉压、脑梗死次数及血液学检查中的血小板含量、活化部分凝血酶原时间、凝血酶原时间。脑梗死患者脑微出血多因素Logistic回归分析结果显示,平均动脉压、心衰、APTT是患者出现脑微出血的独立危险因素。脑白质稀疏严重程度加大后患者脑微出血发生率随之增加。随着腔隙性脑梗死分级的增大,患者脑微出血发生率呈上升趋势。结论脑微出血患者的独立危险因素包括平均动脉压、心衰以及APTT,脑微出血的发生与急性脑梗死没有直接关系,抗栓溶栓治疗并不是脑微出血出现的危险因素,急性脑梗死合并脑微出血患者既存在颅内较大血管病变,又存在微血管病。
Objective To study the related risk factors of cerebral micro-hemorrhage in patients with acute cerebral infarction and elucidate the relevant mechanisms of cerebral micro-hemorrhage in patients with acute cerebral infarction. Methods Seventy-six patients with cerebral infarction who were admitted to our hospital from January 2012 to September 2015 were enrolled in this study. All patients underwent MRI with SE (spin echo sequence), FSE (fast spin echo sequence), FE (field echo sequence) GRE (Gradient Echo) scan to investigate the factors affecting cerebral micro-hemorrhage in patients with acute cerebral infarction. All the risk factors were classified, summarized, classified and analyzed by χ ~ 2 test and multiple regression analysis. Results The patients had micro-hemorrhage of cerebral hemorrhage, including age, history of drinking tea, history of chronic obstructive pulmonary disease, lacunar infarction, sparse white matter, history of hypertension, history of heart failure, mean arterial pressure, number of cerebral infarction and blood Platelet content in the exam, activated partial prothrombin time, prothrombin time. Logistic regression analysis showed that mean arterial pressure, heart failure and APTT were independent risk factors for cerebral micro-hemorrhage in patients with cerebral infarction. After the white matter sparse severity increased, the incidence of cerebral micro-hemorrhage increased. With the increase of lacunar infarction grading, the incidence of cerebral micro-hemorrhage in patients is on the rise. Conclusions Independent risk factors of cerebral micro-hemorrhage include mean arterial pressure, heart failure and APTT. There is no direct relationship between cerebral micro-hemorrhage and acute cerebral infarction. Antithrombotic therapy is not a risk factor for cerebral micro-hemorrhage. Acute cerebral infarction Patients with cerebral micro-hemorrhage in both the existence of larger intracranial vascular disease, there are microvascular disease.