| Objective Oxidative stress injury after acute cerebral infarction（AIS）is the basic mechanism of brain injury,which can damage the blood-brain barrier and aggravate neurological deficits.Hemorrhagic transformation（HT）is a part of the natural course of acute cerebral infarction,the occurrence of HT is related to oxidative stress,it is divided into hemorrhagic cerebral infarction（HI）and parenchymal hematoma（PH）.The occurrence of HT makes the treatment of AIS further troubled,and the ypes of HT have very different effects on AIS.Methods This article retrospectively collected AIS patients who visited the clinic within 1 day of onset,collected relevant clinical data,and recorded at least 3 consecutive times（onset day 1,onset day 2,onset day 6-10）,and serum levels of 2-4 weeks after onset UA and MMP-9 values,calculate the maximum UA difference AUA and the maximum MMP-9 difference ΔMMP-9.HT:No hemorrhage was found in the first CT or MRI after cerebral infarction,but intracranial hemorrhage was found in the second CT or MRI,or hemorrhagic transformation that could be determined by the first CT or MRI,and it was further divided into HI and PH.Short-term prognosis:grouped according to the modified Rankin Scale（mRS）score,good prognosis group:mRS score<3 points,poor short-term prognosis group:mRS score>3 points.Univariate analysis was performed in the statistical software SPSS 25,and statistically significant independent variables were selected for further multivariate regression analysis to explore the relationship between UA、MMP-9、ΔUA and ΔMMP-9 with hemorrhagic transformation and prognosis.At the same time,the interaction between UA and MMP-9 was analyzed.Results 1.A total of 255 AIS patients were included,including 18 in the HI group,17 in the PH group,and 220 in the non-HT group;291.00（235.00,315.75）（P<0.01）,the level of MMP-9 in the PH group（259.53 ± 31.05）was higher than that in the non-HT group（109.60±41.37）and the HI group（132.11 ± 44.28）（P<0.01）.Multivariate Logistic regression analysis:UA（OR=0.970,P=0.039）,MMP-9（OR=1.130,P=0.020）were independent predictors of PH;2.There were 189 cases in the good prognosis group and 66 cases in the poor prognosis group.The UA of the poor prognosis group was 291.00（235.00,315.75）lower than that of the good prognosis group 309.50（258.00,366.00）（P<0.01）;the MMP-9 level of the poor prognosis group was 194.50（171.00,222.50）higher than 91.00（85.00,101.50）in the good prognosis group（P<0.01）;Multivariate Logistic regression analysis:UA（OR=0.981,P=0.000）,MMP-9（OR=1.029,P=0.001）)were independent predictors of poor prognosis.3.Pearson correlation analysis:UA and MMP-9 showed a low degree of negative correlation（r=0.283,P<0.001）.4.235 cases（92%）had decreased UA（ΔUA>0）.Multivariate Logistic regression analysis showed that ΔUA was independently correlated with PH（OR=1.071,P=0.007）and poor prognosis（OR=1.035,P=0.003）.232 cases（91%）had increased MMP-9（ΔMMP-9<0）.Multivariate Logistic regression analysis showed that ΔMMP-9 value was associated with PH（OR=1.031,P=0.000）and poor prognosis（OR=1.058,P=0.000）independently correlated.Conclusions UA and MMP-9 both are one of the serum markers for predicting PH and prognosis;after the occurrence of AIS,serum UA will have a downward trend,and serum MMP-9 will have a rising trend,with a decreasing value of ΔUA and an increased value ofΔUA.ΔMMP-9 was independently associated with PH and risk of poor prognosis;UA and MMP-9 showed a negative correlation. |
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