Yang Junhua, Liu Qingyuan, Mo Shaohua, Wang Kaiwen, Li Maogui, Wu Jun, Jiang Pengjun, Yang Shuzhe, Guo Rui, Yang Yi, Zhang Jiaming, Liu Yang, Cao Yong, Wang Shuo
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Front Aging Neurosci. 2021 Jul 2;13:681998. doi: 10.3389/fnagi.2021.681998. eCollection 2021.
The effect of antiplatelet therapy (APT) on early postoperative rehemorrhage and outcomes of patients with spontaneous intracerebral hemorrhage (ICH) is still unclear. This study is to evaluate the effect of preoperative APT on early postoperative rehemorrhage and outcomes in ICH patients.
This was a multicenter cohort study. ICH patients undergoing surgery were divided into APT group and no antiplatelet therapy (nAPT) group according to whether patients received APT or not. Chi-square test, -test, and Mann-Whitney test were used to compare the differences in variables, postoperative rehematoma, and outcomes between groups. Multivariate logistics regression analysis was used to correct for confounding variables, which were different in group comparison.
One hundred fifty ICH patients undergoing surgical treatment were consecutively included in this study. Thirty five (23.33%) people were included in the APT group, while 115 (76.67%) people were included in the nAPT group. The incidence of early postoperative rehemorrhage in the APT group was significantly higher than that in the nAPT group (25.7% VS 10.4%, = 0.047 < 0.05). After adjustment for age, ischemic stroke history, and ventricular hematoma, preoperative APT had no significant effect on early postoperative rehemorrhage ( = 0.067). There was no statistical difference between the two groups in early poorer outcomes ( = 0.222) at 14 days after surgery. After adjustment for age, ischemic stroke history, and ventricular hematoma, preoperative APT also had no significant effect on early poorer modified Rankin Scale (mRS) ( = 0.072).
In conclusion, preoperative APT appears to be safe and have no significant effect on early postoperative rehematoma and outcomes in ICH patients.
抗血小板治疗（APT）对自发性脑出血（ICH）患者术后早期再出血及预后的影响尚不清楚。本研究旨在评估术前APT对ICH患者术后早期再出血及预后的影响。
这是一项多中心队列研究。接受手术的ICH患者根据是否接受APT分为APT组和非抗血小板治疗（nAPT）组。采用卡方检验、t检验和曼-惠特尼U检验比较两组间变量、术后再出血及预后的差异。采用多因素logistic回归分析校正组间比较中不同的混杂变量。
本研究连续纳入150例接受手术治疗的ICH患者。APT组纳入35例（23.33%），nAPT组纳入115例（76.67%）。APT组术后早期再出血发生率显著高于nAPT组（25.7%对10.4%，P = 0.047 < 0.05）。在调整年龄、缺血性卒中病史和脑室血肿后，术前APT对术后早期再出血无显著影响（P = 0.067）。术后14天两组早期不良预后（P = 0.222）无统计学差异。在调整年龄、缺血性卒中病史和脑室血肿后，术前APT对早期改良Rankin量表（mRS）评分也无显著影响（P = 0.072）。
总之，术前APT似乎是安全的，对ICH患者术后早期再出血及预后无显著影响。
