Analysis Of Risk Factors For Hemorrhage Transformation And Prognosis In Patients With Acute Cerebral Infarction After Intravenous Thrombolysis

Objective:Retrospective analysis of possible risk factors for hemorrhagic transformation and prognosis after intravenous thrombolysis in patients with acute ischemic stroke,which provides a reference for clinicians in risk assessment of hemorrhagic transformation and prognosis after thrombolysis.Methods:A retrospective analysis of 57 patients with acute ischemic stroke treated by intravenous thrombolytic therapy in 6h from January 2015 to October 2017 in our Hospital.We reviewed whether there were hemorrhage transformation of cranial CT and divided them into HT group and non HT group,the risk factors related to HT were selected according to the clinical and laboratory data before thrombolysis,and the independent risk factors of HT were further analyzed by Logistic regression.According to the 30 day mRS score,0~2 scores and > 2 scores were divided into good prognosis group and poor prognosis group.According to its clinical data,univariate analysis was used to analyze its possible risk factors.Multivariate regression analysis was used to analyze the independent risk factors.Results:57 thrombolytic patients,15 cases had symptomatic intracranial hemorrhage(26.32%),and 2 cases died(13.33%),20 cases poor prognosis(35.1%).Single factor analysis showed that NIHSS score before thrombolysis,2 hours NIHSS score after thrombolysis,atrial fibrillation and APTT were related to HT after thrombolysis,and Logistic regression analysis showed that the higher NIHSS score was related to HT after 2 hours of thrombolytic therapy(OR:1.162,95%CI 1.054~1.281,P=0.003).A single factor analysis of age,pre thrombolytic NIHSS score,2 hour NIHSS score after thrombolysis and atrial fibrillation were associated with the prognosis of thrombolysis.Multiple factor Logistic regression analysis suggested that the high NIHSS score of 2 hours after thrombolysis is a risk factor for poor prognosis(OR:2.537,95%CI 1.310 to 4.910,P=0.006).Conclusions:The NIHSS score of 2 hours after thrombolysis is a risk factor for HT and poor prognosis in patients with acute ischemic stroke.