目的 探讨高血压脑出血并发大面积脑梗死的危险因素。方法 对165例高血压脑出血患者临床资料进行回顾性分析,总结导致梗死的可能因素,对有可能导致脑出血后脑梗死的危险因素进行单因素和多因素分析,多因素分析用Logistic逐步回归。结果 Logistic逐步回归分析表明,脑组织移位距离(OR=2.439,95% CI 1.371～4.303)、水肿范围(OR=1.502, 95% CI 1.166～31.935)、血肿量(OR=1.438,95% CI 1.068～1.908)、高血压病史(OR=1.026,95% CI 1.032～1.110)、舒张压(1.019,95% CI 1.011～1.028)和收缩压(OR=1.017,95% CI 1.008～1.026)是影响脑出血后并发脑梗死的危险因素。结论 高血压脑出血后并发大面积脑梗死形成是血管内外多重因素共同作用的结果。其中,脑组织移位距离、水肿范围、血肿大小、高血压病史长短、舒张压及收缩压程度为主要影响因素。

Objective To study the influencing factors of the hypertensive cerebral hemorrhage complicated with massive cerebral infarction patients. Methods Retrospective analysis was conducted of 165 cases of hypertensive cerebral hemorrhage, and the possible factors that might cause cerebral infarction were summed up. Single factor analysis and multiple factors analysis were done to analyze the relationship between these factors and massive cerebral infarction after hypertensive cerebral hemorrhage. Multiple factors analysis was conducted using Logistic regression analysis, α=0.05. Results Logistic stepwise regression analysis screened out such factors as the shift extent of brain (OR=2.439,95% CI 1.371-4.303), the volume of edema (OR=1.502,95% CI 1.166-31.935), the size of hematoma (OR=1.438,95% CI 1.068-1.908), the history of hypertension (OR=1.026,95% CI 1.032-1.110), diastolic pressure(1.019,95% CI 1.011-1.028) and systolic pressure(OR=1.017,95% CI 1.008-1.026) that would influence the massive cerebral infarction after hypertensive cerebral hemorrhage. The correlation degree was not high with the age, plasma osmotic pressure and blood sugar. Conclusions The hypertensive cerebral hemorrhage complicated by massive cerebral infarctin is the interactive effect of the multiple factors. The shift extent of brain, the extent of edema, the size of hematoma, the extent of edema, the history of hypertension and the degree of diastolic pressure and systolic pressure are all the influence factors.