| The technical terms,Cerebral infarction after cerebral hemorrhage, also called hemor- rhagic infarction(HI),referring to the secondary hemorrh age of the infarction region of cerebral arterial thrombosis,was drawn off by Fisher and others in the 1950s. HI is by no means rare in clinical field, and the case fatality rate is high. HI has been turned gradually from the postmortem examination diagnosis to the clinical diagnosis ,along with the widespread application of CT and MRI, and has been known even deeper and deeper day by day. Appraisal and the argument of the treatment of Thrombolysis and Anticoagulation to the acute cerebral arterial thrombosis attracts more people's attention. Hemorrhagic infarction is the clinical common illness, its mortality rate is high. It is the special form of cerebral infarction, most cases of hemorrhagic infarction is a natural event during the course of cerebral infarction, may also caused by the anti-thrombus treatment,and is often considered as the serious complication of the anti-thrombus treatment. Along with the development and pervasion of medical imageology, the clinical detection rate and the ultraearly diagnosis of hemorrhagicinfarction enhances unceasingly,that provides the directory scientific basis to the Thrombo- lysis treatment within 3~6h and Anticoagulation treatment or not at the acute stage after that to the acute cerebral infarction patients,and also reduce medical source hemorrhagic infarction rate and the encephalic haematoma formation rate caused by Thrombolysis and Anticoagulation.However, hemorrhagicinfarction still has a high natural disease incidence rate ,clinically.The most important thing now is,how to control hazard factors of cerebral hemorrhage after cerebral infarction and control them in the seeds to let it to be more advantageous to patient's treatment and the recovery.Objective:Study and discuss the influencing factors and clinical characteristics of cerebral hemor- rhage after cerebral infarction.Study whether the occurrence of HI receives the multiple-factor restrictions:infarction type, infarction spot, infarct size ,blood pressure, blood sugar, age and so on factors; also receives the restrictions of medicines of thromboly, defiberasion, anticoa- gulation,antiblood platelet and so on,so that to get the method to control hemorrhagi- cinfarction effectively.Method: There are 616 cases of acute cerebral infarction hospitalized by Nerve internal medicine departments of the Daqing Oil Field General hospital and the 3rd hospital Jilin University from January, 2006 to October, 2008, all the cases conform to the diagnostic code formulated by the fourth national blood vessel of brain conference. Among them,there were 91 cases of large area cerebral infarction,63 cases of cerebral embolism,259 cases of lacunar infarction,66 cases of hemorrhagic- infarction proved by CT and(or) MRI,10.71% of the whole cases of acute cerebral infarction mentioned.Among the 66 cases, 38 men, 28 women, age 63.1±10.3(30-81),men:women=1.36:1,47 cases(71.21%) accept medicine treatment of antiplatelet, defiberasion, 10 cases(15.15%) accept antico- agulant,7 cases (10.61%) accept thrombolysis. 66 cases,who have identified diagnosis of HI, are taken as observation group,110 cases without HI,are taken as control group, who have the same sex and the same season to fall ill as the cases of observation group. All the selected data, gotten from schedule table after verification and arrangement, are set up a data file library. Normalize the rate and Carry on the equalized comparison to the observation group and the control group, and then carry on the single factor analysis from the correlation factors to be analyzed, the comparison of enumeration data processing applies the chi-square test, the comparison of measurement data applies the T-test. It has the significant difference if P<0.05. Calculate P value of various factors. Consider the joint action of many influencing factors to the Cerebral infarction after cerebral hemorrhage. Carry on the multi-factor analysis by integrating all the influential factors into logistic regression model,select the stepwise regression method, screen influencing factors, according to hypothetical examination standard(α=0.05). Carry on analysis and computation by SPSS 13.0 For Windows statistical software.Result:demonstration of Single factor analysis:1.Relations of HI and cerebral embolism: The patients of cerebral embolism have higher probability of having HI than the patients of cerebral thrombus.There are remarkable differences between the two kinds of patients, P <0.01.2.Relations of HI and infarction area: The bigger the infarction area is, the higher the probability of having HI is, there is a remarkable difference between large area cerebral infarction and lacunar cerebral infarction, P<0.01.3.Relations of HI and cerebral cortex infarction:The more the cerebral infarction implicates,the higher probability of having HI is,there is a remarkable difference between cerebral cortex infarction and cerebral subcortex infarction, P <0.01. 4.Relations of HI and Hyperglycemia: The rate of having HI increases, along with blood sugar value elevation,there is a remarkable difference between the two situations :when the blood sugar value is above 7.0mmol/l and when the blood sugar value is under 7.0mmol/l, P<0.01.5.Relations of HI and third-level hypertension: The rate of having HI increases, along with blood pressure value elevation,there is a remarkable difference between third-level hypertension and hypertension below third-level, P<0.01.6.Relations of HI and age:There is a remarkable difference of having HI between advanced age(≥60years old) and low age(<60years old), P<0.01.Single factor analysis reflects only the independent influence of the single influencing factor to the result,it is hard to describe the unification of multiple influencing factors to the result. It is also difficult to explain which actors is actually related to HI.Through the multi-factor analysis, may simultaneously analyze joint action of multiple influencing factors to the result.Reject the irrelevant disturbed factor, obtain the real result.Take the actors:nature of cerebral infarction, infarction area of cerebral infarction,spot of cerebral infarction, hyperglycemia, hypertension, age, and the actors added to: medicine treatment of defiberasion, anti-blood platelet,anticoagulation and urokinase vein thrombolysis, which are confirmed to have the explicit relevance with HI,altogether nine factors as an independent variable,integrate them to the logistic regression model to have the multi-factor analysis, select the stepwise regression method, screen influencing factors, according to hypothetical examination standard(α= 0.05).There are nine statistical significance factors,gotten by multifactor regression analysis. Cerebral embolism, cerebral cortex infarction,age≥60, blood-fasting sugar≥7mmol/l,large area cerebral infarction, third-level hypertension, defiberasion, anti-blood platelet,anticoagulation and vein thrombolysis, are the risk factors of having HI,they are close related with HI.Conclusion:1.The occurrence of HI receives the multiple factor restrictions:infarction type, infarction spot, infarct size ,blood pressure, blood sugar, age and so on factors; also receives the restrictions of medicines of thromboly defiberasion, antico- agulation,anti-blood platelet and so on.2.Control blood sugar,blood pressure effectively, and carry on thromboly,defiberasion, anticoagulation,anti-blood platelet and so on treatments properly, according to the nature and size of patient's disease,so that to avoid HI occurrence,And control HI at the most mild degree.
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