【摘要】 目的分析缺血性脑卒中住院治疗过程中继发出血的原因及预防措施。方法比较48例住院治疗过程中的急性缺血性脑卒中继发出血前后血清C-反应蛋白、溶血磷脂酸数值;并与252例非出血组脑梗死患者对比,比较溶栓、抗凝、抗血小板、降纤治疗及一般活血化瘀治疗继发出血发生率,进行组间对比及统计学分析。结果出血组在继发出血前血清C-反应蛋白、血清溶血磷脂酸数值。与非出血组间比较,差异无显著性(P>0.05),继发出血后出血组的C-反应蛋白、血清溶血磷脂酸数值明显高于出血前,差异具有显著性(P<0.01),并且各时间段均高于非出血组(对照组),差异均具有显著性(P<0.01)。溶栓、抗凝、抗血小板、降纤治疗及一般活血化瘀治疗继发出血发生率在统计学差异不存在显著性(P>0.05),凝血功能检查比较出血前后各组间数值统计学分析差异无显著性(P>0.05)。结论急性缺血性脑卒中治疗过程中继发出血与炎性反应、应激状态及个体差异密切相关,这类患者发生缺血性脑卒中后缺血灶周围炎性反应明显强于普通脑卒中患者,这可能与血管壁基础病变的严重程度及发病后炎性反应和应激反应过强有关。更多还原

【Abstract】 Objective To analyze the changes of C-reaction protein(CRP) and lysophosphatidic acid(LPA) levels in blood serum to explore the cause of secondary cerebral hemorrhage after acute ischemic stroke.Methods① Monitoring 48 cases of the acute ischemic stroke Plasma LPA levels and serum CRP levels at the time of after acute ischemic stroke, 4 d, 7 d, 14 d compares with 252 patients of ischemic stroke.②To compare the secondary cerebral hemorrhage probability about treatment of debase fibers, anti-coagulang, anti-platelet solve thrombus and traditional Chinese herbals and compares the changes about the function of blood coagulation and TH rates of 5 therapy methods.ResultThe levels of CRP and LPA have no significant difference between two groups before secondary cerebral hemorrhage(P >0.05).At the time of 4 d, 7 d, 4 d the group of secondary hemorrhage CRP and LPA levels increased significantly than that of control group(P <0.01).At the time of 4 d, 7 d, 14 d the group of secondary hemorrhage CRP and LPA levels increased significantly than before treatment(P <0.01).At the time of hemorrhage the function of blood coagulation has no significant difference after therapy than before therapy(P >0.05).TH rates has no significant difference in 5 therapy methods(P >0.05).ConclusionThe secondary cerebral hemorrhage of the patient ischemic stroke are related to many factors The key factor is the inflammatory reaction of cerebravascular and stress state.If the levels of inflammatory maker is significant high, using anti-inflammatory drugs to prevent secondary cerebral hemorrhage may be a good method.更多还原