抗凝及抗血小板药物治疗与颅内出血的关系分析.pdf

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1、河南实用神经疾病杂志2003年9月第6卷第5期HenanJournaiofPracticaiNervousDiseasesSep2003.Vo1.6No.5·1··论著·抗凝及抗血小板药物治疗与颅内出血的关系分析王运良包仕尧石向群鲍欢苏州大学附属第二人民医院神经内科苏州215004【摘要】目的探讨口服抗凝及抗血小板药物治疗有关颅内出血的危险因素，分析与此相关的临床和放射学资料。方法所有病例分为3组，1组为与抗凝及抗血小板有关的颅内出血病人，对病人CT表现、临床症状、血小板、凝血因子筛选试验，出血部位和体积，住院30d死亡率进行分析。2组随机选取同期住院的自发

2、性脑出血病人，方法同上。3组为长期口服抗凝及抗血小板药物而无颅内出血者。结果1组与2组比较，前者有卒中史者比较高，出血体积大，临床表现重，预后差。1组与3组相比较，抗凝及抗血小板治疗时间短，血小板数减少，凝血酶原时间、凝血酶时间延长。结论抗凝及抗血小板治疗有关的颅内出血比自发性颅内出血体积大，死亡率高，抗凝及抗血小板药物过量是主要危险因素。对抗凝及抗血小板治疗病人应定期进行止血功能检测，尤其在第1年，有助于减少颅内出血的发生。【关键词】抗凝剂抗血小板剂颅内出血危险因素Analysistherelationofanticoagulantandantiplate

3、lettreatmentwithintracranialhemorrhageWANGYun-liang，BAOShi-yao，SHIXiang-gun，etal.DepartmentofNeurology，thesecondaffiliatedhospitalofSuzhouUniuersity，Suzhou215004【Abstract】ObjectiveTodetectriskfactorsofintracraniaihemorrhag（eICH）inpatientswithoraianticoaguiantandantipiateiettreatmen

4、t，anaiysisthereiativedatesofciinicaiandradioiogicai.MethodsAiipatientsweredividedinto3groups.Group1representswhowereICHpatientswithoraianticoaguiantandantipiateiet.AnaiysistheirCTexpresion，ciinicaidates，piateietcounts，hemostasisfactorsseiectiontriai，iocationandvoi-umeoftheICH，and33

5、daysin-hospitaimortaiity.Group2consistedofpatientsseiectedatrandomamongaiipatientswithspontaneousICHadmittedtoourdepartmentduringthesameperiodoftime.methodwasasiikeasabovementioned.Group3werereguiariytakingoraianticoaguiantandan-tipiateietdrugswithoutICHpatients.ResultsComparedGrou

6、p1withGroup2，Group1hadmorepatientswithischemicdiseasehistory，bieedingvoiumewasiarger，ciinicaisignsseverity，andprognosiswereworse.ComparedGroup1toGroup3，thetimeoforaianticoaguiantandantipiateietinGroup1wasshort，piateietcountsweredrease，prothrombintim（ePT）andthrombintim（eTT）wereiengt

7、hen.ConclusionBieedingvoiumeinpatientswithanticoaguiantandantipiateietisiargerthanpatientswithspontaneousICH，mortaiityishigher，moreischemicstrokehistoryandtheirpiateietcountsdrease，otherparemeterswithoutsignificantiydifference.Forpatientswhoreguiariytakingoraianticoaguiantandantipi

8、ateietdrugsshouidbegivenhe