抗栓治疗与脑微出血及缺血性脑卒中后出血转化的关系

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1、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岀血转化(HT)的关系.方法选择127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U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〉0.05)，合并CMBs的抗血小板治疗患者(10.4%)与抗凝治疗患者(1

2、4.3%)相比差异无显著性(χ2=0.324,P=0.569).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〉0.05),CMBs阴性组未发现新的CMBs.CMBs阳性组发生HT3例(8.82%),CMBs阳性组发生HT8例(8.60%)，两组比较差异无统计学意义(χ2=0.002,P=0.969).结论抗栓治疗与CMBs的发生及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】ObjectivTostudytherelationshipabouttheantithrombotictherapywithce

3、rebralmicrobleedsandpost—ischemicstrokehemorrhagictransforGmation(HT).MethodsToselect127casesofacuteischemicstrokepatients,SWIsequencewasperformedwithin3daysafteradmission,thepatientsweredividedintoCMBspositivegroupandnegativegroup.ThenumberofCMBs,thelocationandnumberoflesionswererecorded.Thesexa

4、ndageofpatientsandthehistoryofthepatientsandtheoraldrugresistancewererecorded.Afteradmission,allpatientsweretreatedwithantiplateletoranticoagulanttherapyaccordingtotheprincipleofindividualization.2weeksaftertreatment,SWIandCTwerereviewed.ThetotalnumberandlocationofCMBsandwhetherornotHTinthetwogro

5、upswereobserved.ResultsAntithrombotictherapyandtheincidenceofCMBShadnosignificantlycorrelated(P>0.05).Therewasnosignificantdifferenceintheantiplatelettherapypatients(10.4%)andanticoagulationtherapypatients(14.3%)(χ2=0.324,P=0.569).TherewasnosignificantdifferenceinthenumGberofCMBsitesandthetot

6、alnumberofCMBspositivegroup(P>0.05)after2weeksoftreatment,andthenewCMBswasnotfoundinCMBsnegativegroup.IntheCMBSpositivegroup,3caseswereHT(8.82%),lntheCMBSpositivegroup,8caseswereoccurred(8.60%).Thedifferencebetweenthetwogroupswasnosta[tKisetyicwalorsdigsn]ificance(χ2=0.002,P=0.969).Conclusion

7、TheantithrombotictherapyisnotassociatedwiththeoccurrenceofCMBsandHT.Cerebralmicrobleeds;Ischemicstroke;Hemorrhagictransformation;AntithrombotictherapyR743.3B1001—5302(2015)09—0658—02缺血性脑卒中是最常见的卒中类型、脑出血转化(hemorrhagictra