【摘要】 目的研究心房颤动(简称房颤)对急性缺血性脑卒中患者静脉溶栓治疗后发生出血转化的影响。方法采用巢式病例对照研究,回顾性和非随机分析2014年1月至2018年4月西安交通大学第一附属医院卒中中心接受重组组织型纤溶酶原激活剂静脉溶栓治疗的急性缺血性脑卒中(≤4. 5 h)患者211例,依据是否有房颤病史分为脑卒中合并房颤组(63例)和非房颤组(148例)。溶栓后复查头颅CT,观察有无出血转化发生。通过单因素卡方检验和Logistic回归分析研究房颤与急性缺血性脑卒中患者接受重组组织型纤溶酶原激活剂静脉溶栓治疗后发生出血转化的关系。结果 211例患者中,发生出血转化33例,无出血转化178例。其中,急性缺血性脑卒中合并房颤组患者出血转化的发生率为30. 2%(19/63例),高于非房颤组(9. 5%,14/148例),组间比较P <0. 001。结论房颤可能是急性缺血性脑卒中患者重组组织型纤溶酶原激活剂静脉溶栓后发生出血转化的独立危险因素。更多还原

【Abstract】 Aim To evaluate the potential effects of atrial fibrillation( AF) on hemorrhagic transformation( HT) after thrombolytic therapy in acute ischemic stroke( AIS) patients. Methods Using nested case-control studies,a retrospective and non-randomized analysis of 211 patients with AIS receiving recombinant tissue plasminogen activator( rt-PA) thrombolytic therapy( ≤4. 5 h) from the stroke center of the First Affiliated Hospital of Xi’an Jiaotong University from January 2014 to April 2018 were reviewed.After thrombolysis,the head CT was reviewed to see if HT occurred. Univariate and multivariate Logistic regression method were used. Results The incidence of HT in the patients with AIS and AF was higher( 30. 2%,19/63) than that in the non-AF group( 9. 5%,14/148)( P < 0. 001). Conclusion AF may be an independent risk factor of HT in AIS patients receiving thrombolytic therapy.更多还原