Correlations Between Hemorrhagic Transformation After Thrombolysis And Blood Pressure Var Iability With TCM Syndrome Elements

Objective:To analyze the correlations between hemorrhagic transformation (HT) occurred after recombinant tissue plasminogen activator (rt-PA) thrombolysis in patients with acute cerebral infarction (ACI) and different blood pressure variabilities (BPV) at different time periods. To study whether rt-PA thrombolysis induced HT in ACI patients will cause the changes of TCM syndrome elements.Methods:63cases of ACI patients, who were undergone thrombolysis treatment from January2008to February2014in encephalopathy center of Guangdong Traditional Chinese Medicine Hospital, were enrolled in this study for retrospective analysis. General information of included patients, imaging examination results before and after thrombolysis, and blood pressure every2hours within24h before and after thrombolysis were recorded.36BPVs at3different time periods (before thrombolysis and6h after thrombolysis, before thrombolysisandl2h after thrombolysis, and before thrombolysisand24h after thrombolysis) were calculated according to the patient’s blood pressure monitoring. These BPVs include standard deviation(SD) of systolic blood pressure (SBP), SD of diastolic blood pressure (DBP), SD of pulse pressure (PP), SD of mean arterial pressure (MAP), SBP coefficient of variation (CV), DBP CV, PP CV, MAP CV, SBP successive variation (SV), DBPSV, PP SV, and MAP SV. The correlations between HT occurred after rt-PA treatment in ACI patients and different BPVs at different time periods were analyzed. TCM syndrome elements within the24h before and after thrombolysis were collected for statistical analysis on the correlation between HT after thrombolysis and BPVs.Result:For BPVs of the three mentioned time periods, no statistical difference was found between hemorrhagic transformation group (HT group) and non-hemorrhagic transformation groups (NHT group). For the diastolic blood pressure and mean arterial pressure12h after thrombolysis and diastolic blood pressure18h after thrombolysis, statistical differences were found between HT group and NHT group. For the numbers of syndrome elements and syndrome element combination before and after thrombolysis, no statistical difference was found between HT group and NHT group.Conclusion:There was no correlation between BPVs in3time periods (before thrombolysis and6h after thrombolysis, before thrombolysis and12h after thrombolysis, and before thrombolysis and24h after thrombolysis) with rt-PA treatment induced secondary HT within the time window of4.5h from the onset in patients with acute ischemic stroke, which was correlated with the diastolic blood pressure and mean arterial pressure12h after thrombolysis and diastolic blood pressure18h after thrombolysis. HT may correlated with low blood pressure. And there was no statistical difference between rt-PA treatment induced secondary HT in ACI patients with the numbers of syndrome elements and syndrome element combination before and after thrombolysis.