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颅内出血与华法林使用的关系以及华法林和乙酰水杨酸的比较。

Intracranial hemorrhages related with warfarin use and comparison of warfarin and acetylsalicylic acid.

机构信息

Department of Neurology, Atatürk Research and Training Hospital, Izmir, Turkey.

Department of Neurology, Atatürk Research and Training Hospital, Izmir, Turkey.

出版信息

J Stroke Cerebrovasc Dis. 2014 Feb;23(2):321-6. doi: 10.1016/j.jstrokecerebrovasdis.2013.03.008. Epub 2013 Apr 4.

Abstract

BACKGROUND

Acetylsalicylic acid (ASA) and warfarin are used to prevent ischemic cerebrovascular events. They have serious complications including intracranial hemorrhages (ICHs). Warfarin-related intracerebral hemorrhage (ich) incidence is .2%-5% in population that accounts for 10%-12% of all ichs. In this article, we investigated the profile of ASA and warfarin-related spontaneous ICHs in comparison with ICHs without any drug use (WADU) with their clinical, radiological, and biochemical properties.

METHODS

In all, 486 patients aged 18-101 years with spontaneous ICHs were included. Patients constituted 4 separate groups: users of warfarin, ASA, ASA + warfarin, and WADU. Clinical, neurological, etiological, and radiological data of these patients were compared.

RESULTS

There were 32 patients in warfarin, 58 patients in ASA, and 7 in warfarin + ASA group. Most of the patients were in no drug group (389 patients). The most frequent type of hemorrhage was supratentorial intraparenchymal hemorrhage. The most common accompanying disease was hypertension. The number of female patients was statistically significant in the warfarin group. Glasgow Coma Scale (GCS), accompanying diseases, opening of the hematoma to the ventricle, localization of the hemorrhage, age of the patient, and activated partial thromboplastin time level are all related to the outcome of patients. Warfarin users had worst mortality rate.

CONCLUSIONS

Use of warfarin, low GCS score, opening to ventricle, older age, accompanying diabetes, and/or hypertension were worse prognostic factors. It is possible that patients with these unfavorable prognostic factors cannot survive.

摘要

背景

乙酰水杨酸(ASA)和华法林被用于预防缺血性脑血管事件。它们有严重的并发症,包括颅内出血(ICH)。华法林相关的颅内出血(ICH)在人口中的发生率为 0.2%-5%,占所有 ICH 的 10%-12%。在本文中,我们研究了 ASA 和华法林相关自发性 ICH 与无任何药物使用(WADU)ICH 的临床、影像学和生化特征。

方法

共纳入 486 名年龄在 18-101 岁的自发性 ICH 患者。患者分为 4 个独立组:华法林使用者、ASA 使用者、ASA+华法林使用者和 WADU 组。比较了这些患者的临床、神经、病因和影像学数据。

结果

华法林组有 32 例患者,ASA 组有 58 例患者,ASA+华法林组有 7 例患者。大多数患者(389 例)在无药物组。最常见的出血类型是幕上脑实质内出血。最常见的伴随疾病是高血压。华法林组女性患者的数量具有统计学意义。格拉斯哥昏迷量表(GCS)评分、伴随疾病、血肿向脑室开放、出血定位、患者年龄和活化部分凝血活酶时间水平与患者的预后相关。华法林使用者的死亡率最高。

结论

使用华法林、GCS 评分低、向脑室开放、年龄较大、伴有糖尿病和/或高血压是较差的预后因素。可能这些预后不良的患者无法存活。

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