摘要
目的观察预防使用小剂量阿司匹林的老年自发性脑出血患者在急性期的出血量及出血进展情况。方法回顾性收集2015年1月1日~2021年7月31日发病<6 h就诊于解放军总医院第六医学中心及第八医学中心的老年自发性脑出血患者105例。根据患者既往是否使用阿司匹林分为:预防使用阿司匹林组31例(用药组),未预防使用阿司匹林组74例(未用药组),分别收集患者的一般临床资料、阿司匹林使用剂量、用药规律性及时间等,调取发病<6 h及6~72 h的CT断层扫描资料,人工判断血肿形状(Barras量表)。使用倾向性评分匹配方法,去除未匹配数据降低混杂因素干扰后,评估2组匹配后基线水平差异,比较2组患者的出血量、出血进展及血肿形状的差异。结果倾向性匹配前用药组冠心病、脑梗死比例显著高于未用药组(48.4%vs 21.6%,P=0.006;58.1%vs 32.4%,P=0.014);用药组CT2出血量(>45 cm^(3))分层比例显著高于未用药组(32.3%vs 14.9%,P<0.05)。用药组CT1相对不规则血肿形状比例显著高于未用药组(71.0%vs 43.2%,P<0.05)。结论预防使用阿司匹林可能导致老年自发性脑出血患者发生大量出血的风险增加并存在出血增大的风险。
Objective To observe the bleeding volume and bleeding progression in the acute phase in the elderly patients with spontaneous intracerebral hemorrhage after preventively taking low-dose aspirin.Methods The medical records of the elderly 105 patients with spontaneous cerebral hemorrhage who were admitted within 6 h after onset to the Sixth Medical Center and the Eighth Medical Center of Chinese PLA General Hospital from January 1,2015 to July 31,2021 were collected retrospectively.According to whether they preventively took aspirin in the past or not,they were divided into preventive aspirin group(n=31)and non-aspirin group(n=74).The general clinical data,aspirin dosage,medication regularity and duration were collected respectively.The data of computerized tomography(CT)within 6 h and 6-72 h after onset were collected,and the shape of hematoma was judged manually(Barras scale).With the propensity score matching and removal of the unmatched data to reduce the interference of confounding factors,the difference in baseline level was evaluated between the 2 groups after matching,and the differences in bleeding volume,bleeding progression and hematoma shape was compared between the 2 groups.Results The proportions of coronary heart disease and cerebral infarction were significantly larger in the preventive aspirin group than the non-aspirin group(48.4%vs 21.6%,P=0.006;58.1%vs 32.4%,P=0.014).The proportion of CT2 bleeding volume>45 cm^(3)was significantly higher in the preventive aspirin group than the non-aspirin group(32.3%vs 14.9%,P<0.05).The proportion of CT1 relative irregular hematoma shape was significantly higher in the preventive aspirin group than that in the non-aspirin group(71.0%vs 43.2%,P<0.05).Conclusion Preventive use of aspirin may increase the risk of massive hemorrhage and risk of bleeding in elderly patients with spontaneous cerebral hemorrhage.
作者
赵珊
李航
邱峰
刘卓航
潘树义
Zhao Shan;Li Hang;Qiu Feng;Liu Zhuohang;Pan Shuyi(Department of Hyperbaric Oxygen,Sixth Medical Center of Chinese PLA General Hospital,the Second School of Clinical Medicine,Southern Medical University,Beijing 100048,China)
出处
《中华老年心脑血管病杂志》
北大核心
2022年第6期630-633,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
海军后勤科研重点项目(BHJ17L018)。
