磁敏感加权成像在缺血性脑卒中双抗治疗致脑微出血的临床应用研究

磁敏感加权成像在缺血性脑卒中双抗治疗致脑微出血的临床应用研究

黄苗,马兴顺,康林娥,师仰宏,杨兴亮,柴玉梅,薛瑶,白艳艳,乔子梅,张伟靖

榆林市第一医院,榆林市第一医院,榆林市第一医院,榆林市第一医院,榆林市第一医院,榆林市第一医院,榆林市第一医院,榆林市第一医院,榆林市第一医院,榆林市第一医院

收稿日期:2017-07-13 修回日期:2017-12-24 出版日期:2017-12-25
基金资助:
2014年榆林市科学技术研究与发展计划自筹项目（项目编号：2004yyws-03；项目名称：磁敏感加权成像在缺血性脑卒中双抗治疗致脑微出血的临床应用研究)

Clinical Application of Susceptibility Weighted Imaging in Patients with Cerebral Hemorrhage Caused by Dual Antiplatelet Treatment of Ischemic Stroke

Huangmiao,Ma xingshun,Kang Line,Shi Yanghong,Yang Xingliang,Chai Yumei,Xue Yao,Bai Yan Yan,Qiao Zimei and Zhang Weijing

First hospital of Yulin city,First hospital of Yulin city,First hospital of Yulin city,First hospital of Yulin city,First hospital of Yulin city,First hospital of Yulin city,First hospital of Yulin city,First hospital of Yulin city,First hospital of Yulin city,First hospital of Yulin city

Received:2017-07-13 Revised:2017-12-24 Online:2017-12-25

摘要/Abstract

摘要： 目的：通过应用磁敏感加权成像（SWI）技术，采用对照研究对接受双抗治疗的缺血性脑卒中患者进行检测，早期发现脑微出血。方法：选取我院神经内科2015年6月至2016年12月住院期间急性缺血性脑卒中患者行磁敏感加权成像检查颅内微出血小于5个的120例患者给予双抗治疗（阿司匹林肠溶片100 mg·d-1和氯吡格雷片75 mg·d-1）。患者分别于治疗后第10天、20天、30天行磁敏感加权成像检查观察有无颅内微出血。完成30d治疗的患者根据磁敏感加权成像影像结果，分别记录两组第10天、20天、30天的脑微出血（CMB）病灶数目小于等于5个与大于5个的例数，进行统计学分析。结果：双抗治疗后小于或等于5个脑CMB的第10天、20天、30天例数分别为：5例、9例、10例。第20天、第30天分别与第10天相比差异均无统计学意义（P>0.05），第30天与第20天相比较差异均无统计学意义（P>0.05）。双抗治疗后大于5个脑CMB的第10天、20天、30天例数分别为：1例、3例、3例。第20天、第30天分别与第10天相比差异均无统计学意义（P>0.05），第30天与第20天相比较差异均无统计学意义（P>0.05）。结论：通过磁敏感加权成像检测接受双抗治疗的缺血性脑卒中患者，可早期发现脑微出血，评估双抗治疗急性缺血性卒中30d是相对安全的，没有增加出血风险，对临床用药有一定指导意义。

Abstract: Objective： To explore the application of susceptibility weighted imaging in patients with ischemic stroke received dual anti-platelet treatment by control study， early detect cerebral microbleeds（CMS）. Methods： 120 cases of acute ischemic stroke hospitalzed in neurology department in our hospital from June 2015 to December 2016 were examined with susceptibility weighted imaging. Those with intracranial micro hemorrhage less than 5 were given dual antiplatelet therapy (aspirin enteric-coated tablets 100mg·d-1 and clopidogrel 75 mg·d-1). Cerebral hemorrhage were observed by susceptibility weighted imaging on 10d， 20d and 30d after the treatment. After 30d of treatment， according to the results of susceptibility weighted imaging， case of CMB≤5 were recorded and statistic analyzed on 10d， 20d and 30d respectively. Results： The number of less than or equal to 5 brain CMB on 10d， 20d and 30d were 5 cases， 9 cases， 10 cases. Compared with 10d， the differences on 20d and 30d were not statistically significant (P>0.05)； the difference between 30d and 20d was not statistically significant (P>0.05). The number of CMB>5 on 10d， 20d and 30d were 1 case， 3 cases， 3 cases. Compared with 10d， the differences on 20d and 30d were not statistically significant (P>0.05)； difference between 20d and 30d was not statistically significant (P>0.05).Conclusion： Evaluated by early detection of cerebral hemorrhage by susceptibility weighted imaging， dual anti-platelet therapy for 30 days is relatively safe in acute ischemic stroke， without any increase in risk， and has some guiding significance for clinical medication.

黄苗,马兴顺,康林娥,师仰宏,杨兴亮,柴玉梅,薛瑶,白艳艳,乔子梅,张伟靖. 磁敏感加权成像在缺血性脑卒中双抗治疗致脑微出血的临床应用研究[J]. .

Huangmiao,Ma xingshun,Kang Line,Shi Yanghong,Yang Xingliang,Chai Yumei,Xue Yao,Bai Yan Yan,Qiao Zimei and Zhang Weijing. Clinical Application of Susceptibility Weighted Imaging in Patients with Cerebral Hemorrhage Caused by Dual Antiplatelet Treatment of Ischemic Stroke[J]. .

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