Analysis of risk factors for hemorrhagic transformation after cerebral infarction / 中国脑血管病杂志

ABSTRACT

Objective: To investigate the risk factors for hemorrhagic transformation (HT) in patients with cerebral infarction. Methods: The clinical data of 960 patients with cerebral infarction admitted to the Department of Neurology, Hangzhou First People's Hospital Affiliated to Nanjing Medical University were analyzed retrospectively. They were divided into HT group (n =90) and non-HT group (n =870) according to whether they had HT or not. The blood pressure, postprandial and fasting blood glucose, cholesterol levels, infarct size detected by imaging, atrial fibrillation and thrombolysis within 24 hours of admission, anticoagulant therapy before or after admission, previous history of anti-platelet aggregation therapy and TOAST classification in both groups were observed. The risk factors for HT were identified by univariate chi-square test and multivariate logistic regression analysis, and the incidences of HT in various types of cerebral infarction in the TOAST classification were compared. Results: Circled digit oneThe results of multivariate logistic regression analysis showed that massive cerebral infarction (P = 0.000, OR = 10. 519, 95% CI 6. 600-16. 766), atrial fibrillation (P = 0. 006, OR = 1. 913, 95% CI 1. 206-3. 003), thrombolysis (P = 0. 033, OR= 2. 502, 95%CI 1.078-5.805), anticoagulation (P = 0. 000, OR = 7. 877, 95% CI 2. 491-25. 911), and postprandial glucose ≥10 mmol/L or fasting glucose ≥7. 0 mmol/L (P = 0. 011, OR = 0. 822, 95% CI 1. 146-2.897) were the independent risk factors for HT. Systolic blood pressure ≥ 180 mm Hg and/or diastolic blood pressure ≥ 110 mm Hg, high cholesterol (≥ 5. 98 mmol/L) , and the history of anti-platelet aggregation were not the independent risk factors for HT. Circled digit twoIn the TOAST classification, the HT incidence in patients with cardioembolic cerebral infarction was the highest (21. 4% , 34/159), the HT incidence of small artery occlusion was lower (1. 1%, 2/181 ), and the HT incidence of large artery atherosclerosis was 8. 6% (51/593). Conclusion: Massive cerebral infarction, atrial fibrillation, thrombolysis, anticoagulation, postprandial glucose ≥ 10 mmol/L or fasting glucose ≥ 7. 0 mmol/L are the independent risk factors for HT. Cardioembolic cerebral infarction is one of the major reasons for the occurrence of HT.