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目的：探讨引起出血性脑梗死（ｈｅｍｏｒｒｈａｇｉｃ ｉｎｆａｒｃｔｉｏｎ，ＨＩ）的危险因素及其发病机制和早期经静脉抗凝、溶栓治疗对ＨＩ形成的影响。方法：收集１６０例急性脑梗死病人的临床资料，根据有无ＨＩ分为ＨＩ组（４９例）、非ＨＩ组（１１１例）。对两组病人的危险因素（年龄、性别、既往高血压史、脑卒中发生７天内平均血压、梗死部位、梗死指数）及早期经静脉抗凝溶栓治疗对ＨＩ形成的影响进行统计学分析。结果：（１）ＨＩ的发生与年龄、梗死指数有关。（２）经静脉抗凝溶栓治疗不增加ＨＩ发生率，但易出现脑实质内血肿。结论：ＨＩ的形成与梗死区血流再通、梗死面积及伴发脑水肿压迫周围毛细血管、增加血脑屏障通透性有关。提倡脑梗死发生后６ｈ内给予经静脉抗凝溶栓治疗，但对治疗过程中出现的ＨＩ应高度重视。
Objective: To investigate the risk factors and pathogenesis of hemorrhagic infarction (HI) and the effect of early intravenous anticoagulation and thrombolysis on the formation of HI. Methods: The clinical data of 160 patients with acute cerebral infarction were collected and divided into HI group (n = 49) and non-HI group (n = 111) according to the presence or absence of HI. The effects of risk factors (age, sex, previous history of hypertension, mean blood pressure within 7 days after stroke onset, infarct size, infarct index) and early intravenous anticoagulant thrombolysis on HI formation were statistically analyzed. Results: (1) The occurrence of HI was related to age and infarct index. (2) intravenous anticoagulant thrombolytic therapy does not increase the incidence of HI, but prone to intracerebral hematoma. Conclusions: The formation of HI is related to the recanalization of blood flow in the infarct area, infarction area and capillaries with compression of cerebral edema, which increases the permeability of the blood-brain barrier. To promote cerebral infarction within 6h after given intravenous anticoagulant thrombolytic therapy, but the treatment process should be given high priority HI.