【摘要】 目的分析磁敏感加权成像(SWI)上毛刷征诊断急性缺血性脑卒中(AIS)患者静脉溶栓后出血转化的价值。方法选取2015年4月至2019年4月我院神经内科行静脉溶栓治疗的AIS患者60例为研究对象,均行SWI检查,分析SWI上毛刷征阳性率及影响因素,并在SWI上将两侧静脉显影程度评分相减(患侧-健侧)得不对称指数(AI),以二元Logistic多元回归分析法分析AIS患者静脉溶栓后出血转化与毛刷征的关系。结果共40例患者SWI上出现毛刷征,毛刷征阳性率为66.67%(40/60);基于毛刷征AI分级的有序Logistic回归分析结果显示,基线美国国立卫生研究院量表(NIHSS)评分、收缩压、心房颤动、低灌注体积为毛刷征AI分级程度的独立影响因素(P<0.05);二元Logistic回归分析显示,AI分级为影响AIS静脉溶栓后出血转化的独立危险因素(OR=1.594,95%CI1.290～1.969,P<0.001)。结论 SWI上毛刷征对AIS患者静脉溶栓后出血转化有重要预测价值,毛刷征越明显的患者在静脉溶栓后发生出血转化的风险更高。更多还原

【Abstract】 Objective To analyze the diagnostic value of hairbrush signs on susceptibilityweighted imaging(SWI) for hemorrhagic transformation(HT) in patients with acute ischemic stroke(AIS) after intravenous thrombolysis(IVT). Methods A total of 60 AIS patients who underwent IVT in neurology department of the hospital from April 2015 to April 2019 were enrolled in the study. All patients underwent SWI. The positive rates of hairbrush signs on SWI and the influencing factors were analyzed. The asymmetry index(AI) was obtained by subtracting scores of venous development degree at two sides(affected side-healthy side). The relationship between HT and hairbrush signs in AIS patients after IVT was analyzed by binary Logistic multivariate regression analysis. Results There were 40 cases with hairbrush signs on SWI, with hairbrush signs positive rate of 66.67%(40/60). The results of ordered Logistic regression analysis based on AI grading of hairbrush signs showed baseline scores of National Institutes of Health Stroke Scale(NIHSS), systolic blood pressure, atrial fibrillation, and low perfusion volume were independent influencing factors of AI grading degree of hairbrush signs(P<0.05). Binary Logistic regression analysis showed that AI grading was independent risk factor influencing HT in AIS patients after IVT(OR=1.594, 95%CI 1.290 to 1.969, P<0.001). Conclusion The hairbrush signs on SWI are important predictive value for HT in AIS patients after IVT. The more obvious the hairbrush signs, the higher the HT risk after IVT.更多还原