摘要
目的 探讨血清胆红素水平与大动脉粥样硬化(LAA)型急性缺血性卒中(AIS)病人静脉溶栓(IVT)治疗后出血转化(HT)的关系.方法 LAA型AIS行IVT后的病人473例,根据是否发生HT分成HT组和非HT(NHT)组.采用多因素logistic回归分析总胆红素、直接胆红素和间接胆红素水平与HT之间的关系.结果 与NHT组比较,HT组的发病到静脉溶栓时间缩短、入院到静脉溶栓时间延长、美国国立卫生研究院卒中量表评分增加(t=5.27～18.00,P＜0.05),总胆红素、间接胆红素和尿酸水平降低(t=2.00～2.28,P＜0.05).血清总胆红素(OR=0.951,95％CI=0.915～0.988)、间接胆红素(OR=0.923,95％CI=0.874～0.974)水平与 HT 呈负相关.结论 血清总胆红素和间接胆红素水平升高能降低LAA型AIS行IVT后病人的HT风险.
Abstract
Objective To investigate the correlation between serum bilirubin level and hemorrhagic transformation(HT)af-ter intravenous thrombolysis(IVT)in patients with the large artery atherosclerosis(LAA)type of acute ischemic stroke(AIS).Methods A total of 473 patients with LAA-type AIS who underwent IVT were enrolled,and according to the presence or absence of HT,they were divided into HT group and non-HT group(NHT group).A multivariate logistic regression analysis was used to investigate the association of the levels of total bilirubin,direct bilirubin,and indirect bilirubin with HT.Results Compared with the NHT group,the HT group had a significantly shorter time from onset to IVT,a significantly longer time from admission-to IVT,and a significant increase in National Institutes of Health Stroke Scale score(t=5.27-18.00,P＜0.05),as well as signi-ficant reductions in the levels of total bilirubin,indirect bilirubin,and uric acid(t=2.00-2.28,P＜0.05).The levels of total bili-rubin(OR=0.951,95％CI=0.915-0.988)and indirect bilirubin(OR=0.923,95％CI=0.874-0.974)were negatively correlated with HT.Conclusion Increases in the levels of total bilirubin and indirect bilirubin can reduce the risk of HT in patients with LAA-type AIS after IVT.
基金项目
吴阶平医学基金会临床科研专项(320.6750.2020-08-27)
国家科技期刊平台
NSTL
万方数据