分析与急性小脑梗死出血性转化相关的因素。

Analysis of Factors Associated with Hemorrhagic Transformation in Acute Cerebellar Infarction.

机构信息

Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong, China.

Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China.

出版信息

J Stroke Cerebrovasc Dis. 2022 Jul;31(7):106538. doi: 10.1016/j.jstrokecerebrovasdis.2022.106538. Epub 2022 May 3.

DOI:10.1016/j.jstrokecerebrovasdis.2022.106538

PMID:35523054

Abstract

OBJECTIVES

Hemorrhagic transformation (HT) is a frequent and severe complication of ischemic stroke. This study aimed to evaluate the factors associated with the occurrence of HT in patients with acute cerebellar infarction.

MATERIALS AND METHODS

A total of 190 patients, 141 male (74.2%) and 49 female (25.8%) with mean age 61.84 ± 12.16 years, who were admitted within 72 h of acute cerebellar infarction onset from January 2017 to March 2021 were retrospectively recruited. The multivariate logistic regression analysis was used to evaluate the independent influent factors for HT and receiver-operating characteristic (ROC) curve was applied to calculate the predictive value of those factors for HT in patients with acute cerebellar infarction.

RESULTS

37 out of 190 recruited patients (19.47%) had HT within 14 days after acute cerebellar infarction onset. The incidence rates of HT occurring within 3 days, 3-7 days and 7-14 days were 13.5%, 40.5% and 45.9%, respectively. Results of the multivariable logistic regression analysis indicated that atrial fibrillation (AF) (OR 6.196, 95% CI 1.357-28.302, P = 0.019), infarct diameter (OR 5.813, 95% CI 2.932-11.526, P < 0.001), white matter hyperintensity (WMH) (OR 2.44, 95% CI 1.134-5.252, P = 0.023) were independent risk factors for HT in acute cerebellar infarction, while lymphocyte count (OR 0.319, 95% CI 0.142-0.716, P = 0.006) showed an independently protective effect.

CONCLUSIONS

Infarct diameter, AF and WMH are independent risk factors for HT in patients with acute cerebellar infarction, while the lymphocyte count is a protective factor.

摘要

目的

出血转化（HT）是缺血性脑卒中的一种常见且严重的并发症。本研究旨在评估与急性小脑梗死患者 HT 发生相关的因素。

材料与方法

回顾性纳入 2017 年 1 月至 2021 年 3 月发病 72 小时内的急性小脑梗死患者 190 例，男 141 例（74.2%），女 49 例（25.8%），平均年龄 61.84±12.16 岁。采用多变量 logistic 回归分析评估 HT 的独立影响因素，并绘制受试者工作特征（ROC）曲线计算各因素对急性小脑梗死患者 HT 的预测价值。

结果

190 例患者中 37 例（19.47%）在急性小脑梗死发病后 14 天内发生 HT。发病 3 天内、3-7 天和 7-14 天内 HT 的发生率分别为 13.5%、40.5%和 45.9%。多变量 logistic 回归分析结果表明，心房颤动（AF）（OR 6.196，95%CI 1.357-28.302，P=0.019）、梗死直径（OR 5.813，95%CI 2.932-11.526，P<0.001）、脑白质高信号（WMH）（OR 2.44，95%CI 1.134-5.252，P=0.023）是急性小脑梗死 HT 的独立危险因素，而淋巴细胞计数（OR 0.319，95%CI 0.142-0.716，P=0.006）则表现出独立的保护作用。