Analysis of hemorrhagic transformation following thrombolytic therapy in acute cerebral infarct patients / 中国医师进修杂志

ABSTRACT

Objective To investigate the risk factors of hemorrhagic transformation (HT) following thrombolytic therapy in acute cerebral infarct patients. Methods The clinical data of 246 cases with acute cerebral infarct treated with rt-PA within 4.5 h from the onset were reviewed. According to the results of brain CT imaging after intravenous thrombolysis for 24-36 h, the patients were divided into HT group and non HT group. The factors including age, gender, NIHSS scores, drinking, smoking, hypertension, diabetes, atrial fibrillation. The univariate analysis and Losgistic regression analysis were further assessed. Results The results of univariate analysis indicated that there were no significant differences between the two groups in age, gender, smoking , drinking, time from onset to thrombolysis, diabetes (P > 0.05), but there were significant differences between two groups in NIHSS scores [(14.53 ± 6.06) scores vs.(9.98 ± 6.26) scores, P = 0.000], hypertension [86.1%(31/36) vs.70.0%(147/210), P = 0.046] and atrial fibrillation [63.9%(23/36) vs. 24.3%(51/210), P = 0.000]. Logistic regression analysis showed that NIHSS scores (OR = 1.079, 95% CI = 1.014- 1.147, P = 0.016) and atrial fibrillation (OR=3.298, 95%CI=1.481-7.345, P=0.003) were the risk factors associated with hemorrhagic transformation after intravenous thrombolysis for acute cerebral infarction. Conclusions NIHSS scores and atrial fibrillation are the risk factors associated with HT after thrombolytic therapy in acute cerebral infarct patients.