Risk factors of hemorrhage after thrombolysis for mild cerebral infarction and the curative effect of low-dose alteplase
10.3760/cma.j.issn.1008-1372.2019.08.015
- VernacularTitle:轻型脑梗死溶栓后出血的危险因素及小剂量阿替普酶治疗效果分析
- Author:
Hongling HOU
1
;
Xinjiang ZHANG
;
Lihong TAO
;
Guoxian SUN
Author Information
1. 扬州大学附属医院神经内科 225001
- Keywords:
Brain infarction;
Thrombolytic therapy;
Intracranial hemorrhages;
Risk factors;
Tissue dlasminogen activator
- From:
Journal of Chinese Physician
2019;21(8):1173-1176,1180
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors of hemorrhage after thrombolysis for mild cerebral infarction and the curative effect of low-dose alteplase.Methods 375 patients with mild cerebral infarction whose onset time was less than 4.5 hours from January 2013 to May 2017 in our hospital were selected as the research objects.Those undergoing low-dose alteplase thrombolysis were included in the thrombolysis group (n =195) while those without thrombolysis were included in the non-thrombolysis group (n =180).The therapeutic effects were analyzed.Patients with intracerebral hemorrhage in the thrombolysis group at 14 days after thrombolysis were included in the observation group while those without hemorrhage were included in the control group.Related data were compared between the two groups.The single factors and independent risk factors of hemorrhage after thrombolysis in patients with mild cerebral infarction were analyzed.Results National Institute of Health Stroke Scale (NIHSS) scores of the thrombolysis group at 1 week,1 month and 3 months after treatment were significantly lower than those of the non-thrombolysis group (P ＜0.05).Serum neuron specific enolase (NSE) and C-reactive protein (CRP) levels in the thrombolysis group were lower than those in the non-thrombolysis group after treatment (P ＜ 0.05).The prognosis of the thrombolysis group was better than that of the non-thrombolysis group after treatment (P ＜ 0.05).In this study,30 patients undergoing thrombolysis had intracerebral hemorrhage within 14 days after thrombolysis,and the incidence of intracranial hemorrhage was 15.38％ (30/195).Univariate and multivariate logistic regression analysis showed that age,history of heart failure,door to needle time (DNT),systolic blood pressure (SBP) in 12 hours after thrombolysis and leukoaraiosis change were risk factors for hemorrhage in patients with mild cerebral infarction after thrombolysis (P ＜ 0.05).Conclusions Using low-dose alteplase for treating patients with mild cerebral infarction can achieve good thrombolytic effects.Age,history of heart failure,DNT,SBP in 12 hours after thrombolysis and leukoaraiosis change are influencing factors of intracranial hemorrhage,which should be paid attention to.
