Analysis Of Risk Factors Related To Hemorrhage Transformation After Intravenous Thrombolysis In Acute Ischemic Stroke

Objective: To analyze the risk factors related to hemorrhagic transformation(HT)in patients with acute ischemic stroke(AIS)after intravenous alteplase(rt-PA)thrombolytic therapy.Methods: This was a retrospective study.According to the inclusion and exclusion criteria,a total of 195 patients diagnosed with AIS and treated with intravenous thrombolysis were enrolled in the Emergency Center of the First Affiliated Hospital of Xinjiang Medical University from August 2019 to May 2022.General clinical data(including gender,age,past history,etc.)and relevant laboratory test results(blood routine,biochemical complete items,coagulation routine,etc.)were collected.Binary Logistic regression analysis and ROC curve analysis were performed for the risk factors of HT after AIS intravenous thrombolysis.Results: There were 26 cases(13.33%)in bleeding group and 169 cases(86.67%)in control group(no bleeding group).National Institutes of Health Stroke Scale(NIHSS)score,baseline prothrombin time(PT),prothrombin activity(PTA),International standardized ratio(INR),thrombin time(TT),creatinine(Cr),estimated glomerular filtration rate(eGFR),neutrophil count(NEUT),glycosylated hemoglobin(HbA1c)and history of atrial fibrillation were statistically significant(P<0.05);Multivariate logistic regression showed that NIHSS score(OR:1.129,95%CI:1.037-1.230)and NEUT(OR:1.247,95%CI: 1.019-1.527)were independent risk factors for HT after intravenous thrombolysis in AIS(P<0.05),eGFR(OR:0.961,95%CI:0.927～0.996),were independent protective factors for HT after AIS intravenous thrombolysis(P< 0.05);The area under ROC curve of NIHSS score,NEUT and eGFR combined to predict HT after intravenous thrombolysis was 0.798(95%CI:0.703～0.893).Conclusions: NIHSS score and NEUT were independent risk factors for HT after intravenous thrombolysis in AIS,and eGFR was independent protective factor for HT after intravenous thrombolysis in AIS.The combination of NIHSS score,NEUT and eGFR had better predictive value for HT after intravenous thrombolysis in AIS.