Analysis Of Risk Factors And Clinical Features Related To Hemorrhagic Transformation In Acute Cerebral Infarction

ObjectiveTo explore the risk factors and clinical features related to hemorrhagic thansformation(HT)in acute cerebral infarction and to provide basis for the development of clinical treatment plan and to improve the cognition of this disease.MethodsThe data of acute cerebral infarction patients collected from the department of Neurology,Second Hospital of Jilin University from September 2016 to November 2017 was retrospectively analyzed.The patients were divided into hemorrhagic transformation group(HT group)and non-hemorrhagic transformation group(non-transfusion group).The demographic characteristics,clinical characteristics,laboratory test results,and treatment options were compared between the two groups.SPSS 21.0 software was used for statistical analysis.Measurement data were analyzed by t-test.Count data were analyzed by χ2test.Binary logistic regression analysis was used to analyze the independent risk factors of hemorrhagic transformation.ResultsAmong the 389 patients with acute cerebral infarction,there were 57 patients who had hemorrhagic transformation confirmed by CT/MRI.In the HT group,the rate of incidence was 14.65%(57/389).There were respectively 27 cases,15 cases,10 cases,and 5 cases with HI type I,HI type II,PH type I,and PH type II imaging,accounting for 47.37%,26.32%,17.54%,8.77% of the total number of patients in the HT group.Comparison of demographic characteristics between HT group and non-HT group showed that the history of diabetes mellitus and atrial fibrillation had statistical significance(P<0.05).The age,sex,place of residence,history of hypertension,smoking,drinking had no significant difference(P>0.05).The history of diabetes accounted for 70.18%(40/57)in the HT group and 55.12%(183/332)in the non-HT group.The history of atrial fibrillation accounted for 66.67%(38/57)in the HT group and 29.52%(98/332)in the non-HT group.Comparison of clinical characteristics between HT group and non-HT group showed that large area of cerebral infarction,infarction involving the cortex,cerebral embolism occurred more likely in patients with hemorrhagic transtormation(HT)(P<0.05).There was significant difference between the two groups in the number of days of hospitalization(P<0.05).Patients with cerebral embolism accounted for 71.93%(41/57)in the HT group and 40.36%(134/332)in the non-HT group.Patients with large area cerebral infarction accounted for 63.16%(36/57)in the HT group and 39.46%(131/332)in the non-HT group.Comparison of the laboratory examination results between the HT group and the non-HT group showed that there was a significant difference in fasting blood glucose and low-density lipoprotein cholesterol(LDL-C)(P<0.05).There was no significant difference in total cholesterol(TC),triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C)(P>0.05).Two-term Logistic regression analysis: Logistic regression analysis of statistically significant factors in the above univariate analysis revealed that cerebral infarction area(OR=4.817,95% CI=3.736 ~ 11.227,P <0.001),cerebral infarction property(OR=3.364,95%CI=1.451~7.018,P=0.004),history of atrial fibrillation(OR=3.021,95%CI=1.254~9.628,P=0.012),fasting blood glucose level(OR=2.098,95%CI= 1.640~8.124,P=0.018),LDL cholesterol(OR=1.871,95%CI=0.516~0.987,P= 0.025),infarct site(OR=1.290,95%CI=1.013~4.625,P=0.043)were risk factors for the development of HT.Conclusion1.Large-areacerebral infarction,cerebral embolism,past history of atrial fibrillation,cerebral cortex involved parts,high blood sugar levels,lower LDL cholesterol levels are risk factors for cerebral hemorrhagic transformation.2.The risk of hemorrhagic transformation in large-area cerebral infarction was significantly higher than that in non-majority cerebral infarction.The risk of hemorrhagic transformation in cerebral embolism was significantly higher than that in cerebral thrombosis.