【摘要】：目的：對(duì)SEDAN、SITS-MOST、iScore和GRASPS4個(gè)急性腦梗死經(jīng)靜脈重組組織型纖維蛋白溶解酶原激活物（rt-PA）溶栓后出血轉(zhuǎn)化的風(fēng)險(xiǎn)預(yù)測(cè)模型進(jìn)行比較并分析各模型所包含的危險(xiǎn)因素。方法：收集自2009年1月至2014年3月之間于重慶醫(yī)科大學(xué)附屬第二醫(yī)院診斷為急性腦梗死，并接受靜脈rt-PA溶栓治療的所有患者資料，利用4個(gè)預(yù)測(cè)模型進(jìn)行評(píng)分，分別對(duì)各模型所包含的危險(xiǎn)因素與是否發(fā)生出血轉(zhuǎn)化的相關(guān)性進(jìn)行單因素分析及Logistic回歸分析，，用Fisher確切概率法及受試者工作曲線（ROC）檢驗(yàn)并比較各模型對(duì)溶栓后出血轉(zhuǎn)化的預(yù)測(cè)能力。結(jié)果：?jiǎn)我蛩胤治鲲@示溶栓前頭部CT平掃顯示早期梗死征象（P0.01）、動(dòng)脈高密度征（P0.01）及溶栓前血糖（P=0.014）與溶栓后出血轉(zhuǎn)化相關(guān)。Logistic回歸分析顯示溶栓前頭部CT平掃顯示早期梗死征象（P=0.036）、動(dòng)脈高密度征（P=0.022）與溶栓后出血轉(zhuǎn)化相關(guān)，既往高血壓病史可能與溶栓后出血轉(zhuǎn)化相關(guān)（P=0.054）。SEDAN模型ROC曲線下面積=0.911，SITS-MOST模型ROC曲線下面積=0.83。結(jié)論：SEDAN與SITS-MOST模型能有效預(yù)測(cè)溶栓后出血轉(zhuǎn)化。
[Abstract]:Aim: to compare the risk prediction models of bleeding transformation after thrombolysis with recombinant tissue plasminogen activator (rt-PA) in 4 acute cerebral infarction patients with SEDAN SITS-MOSTIScore and GRASPS, and to analyze the risk factors involved in these models. Methods: from January 2009 to March 2014, all the patients who were diagnosed as acute cerebral infarction in the second affiliated Hospital of Chongqing Medical University and received intravenous rt-PA thrombolytic therapy were evaluated with four predictive models. Univariate analysis and logistic regression analysis were carried out to analyze the correlation between the risk factors included in each model and the occurrence of hemorrhage transformation. Fisher exact probability method and receiver operating curve (ROC) were used to test and compare the predictive ability of each model for bleeding transformation after thrombolysis. Results: before thrombolysis, CT plain scan showed early infarction sign (P0.01), arterial high density sign (P0.01) and blood glucose before thrombolysis (P0. 014). Logistic regression analysis showed that prethrombolytic head CT plain scan showed early stage. Infarction sign (P0. 036), arterial high density sign (P0. 022) were associated with bleeding and transformation after thrombolytic therapy. The history of hypertension may be related to hemorrhage transformation after thrombolysis (P0. 054). The area under ROC curve of SEDAN model is 0. 911 and the area under ROC curve of SITS-MOST model is 0. 83. Conclusion the model of SITS-MOST and SITS-MOST can effectively predict bleeding transformation after thrombolysis.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 賴繁龍;;一側(cè)大腦中動(dòng)脈高密度征對(duì)腦梗死的早期診斷探討[J];當(dāng)代醫(yī)學(xué);2013年04期

2 王世芳;肖衛(wèi)民;吳志強(qiáng);;急性腦梗死靜脈溶栓后早期腦出血轉(zhuǎn)化的相關(guān)因素分析[J];贛南醫(yī)學(xué)院學(xué)報(bào);2013年02期

3 涂雪松;;出血性轉(zhuǎn)化的影響因素和預(yù)測(cè)指標(biāo)[J];青海醫(yī)藥雜志;2012年09期

4 張澤進(jìn);;血壓變異性與腦梗死溶栓治療后出血轉(zhuǎn)化的相關(guān)性研究[J];中國全科醫(yī)學(xué);2013年28期

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