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Objective To investigate the relationship between spontaneous hemorrhagic transformation and prognosis after cerebral infarction.Methods Three hundred and thirty-seven cases with acute ischemic stroke at the Brain Hospital Affiliated to Nanjing Medical University from Nov.2011 to Jul.2012 were selected as our subjects.All the relevant clinic and laboratory examination data which influencing spontaneous hemorrhagic transformation were collected.Brain CT or MRI within 3 d after admission or when neurological deficit deterioration happened was performed.Based on brain CT scan or MRI,patients were divided into hemorrhagic transformation(HT) group or non-HT(NHT) group.All cases were followed up for 3 month.Results All of 337 patients,44 cases occurred in spontaneous hemorrhagic transformation,accounting for 13.1％.The mortality rate was 6.8％ (3 cases) in 3 months followed-up at HT group,and the death/disability rate was 47.7％ (21 cases).Meanwhile,the mortality rate was 7.5％ (21 cases) in 3 months followed-up at NHT group,and the death/ disability rate was 35.5％ (104 cases).There was no significant difference between the two groups(x2 =3.10,P =0.376).Multivariate logistic regression analysis demonstrated that age (OR =1.054,95 ％ CI 1.021-1.087),gender(OR =2.131,95％ CI 1.151-3.945) and the national institutes of health stroke scale(OR =1.275,95％ CI 1.174-1.384) were independent predictors of death/dependence at 3 months after ischemic stroke attacked.Conclusion Spontaneous hemorrhagic transformation is not the risk factor of death/dependence on 3 month after symptom onset for ischemic stroke patients.Spontaneous hemorrhagic transformation should be detected as early as possible and adjusted therapy scheme in time,which will help in terms of prognosis.
RESUMO
To explore the incidence and risk factors for spontaneous hemorrhagic transformation (HT) of cardioembolism (CE,n =150) and large artery atherosclerotic infarction (LAA,n =370).The incidence of HT was 29.3％ in CE.And it was significantly higher than 9.7％ (P ＜0.05).Infarct size,low-density lipoprotein-cholesterol (LDL-C) and admission National Institutes of Health Stroke Scale (NIHSS) score were independent predictors of spontaneous hemorrhagic transformation in LAA.OR values were 3.92,2.96 and 1.45 respectively.Infarct size,admission NIHSS score and random blood glucose level were independent predictors of spontaneous hemorrhagic transformation in CE.OR values were 4.86,2.42 and 1.42 respectively.As compared with LAA,CE was more prone to HT.LAA and CE-related factors of hemorrhagic transformation are not completely identical.