Analysis Of The Correlation Between The Ratio Of Triglyceride To High-density Lipoprotein Cholesterol And Hemorrhage Transformation After Cerebral Infarction

Research purposes: Hemorrhagic transformation(hemorrhagic transformation,HT)after cerebral infarction is part of the natural course of acute cerebral infarction,and is also a common complication of blood flow therapy(thrombolysis,anticoagulation,antiplatelet,intervention,etc.).It is not only related to the poor prognosis of cerebral infarction,but also an important reason for the obvious insufficient use of the effective therapies metioned above.Identify risks of hemorrhage transformation in early stage will help implement reperfusion and antithrombotic therapy to better select patients whose benefits are greater than the risk of bleeding,maximize the benefits of treatment and minimize the risks,which is conducive to more precise and individualized treatment.In recent years,there have been increasing amout of studies on blood biochemical markers in patients with hemorrhage transformation.Recent studies have found that there is relationship between the ratio of low triglycerides to high-density lipoprotein cholesterol(TG/HDL-C),and hemorrhagic transformation after large atherosclerotic cerebral infarction.This study intends to analyze the risk factors for hemorrhagic transformation,especially the correlation between TG/HDL-C and hemorrhagic transformation after large atherosclerotic acute cerebral infarction,to verify whether it can be used as a risk factor for predicting HT,and whether it can be HT Early detection provides new blood biochemical markers to help early identification of high-risk groups of HT in acute cerebral infarction,thereby helping clinicians to prevent and treat HT early.Research method: Collecting the data of patient,from December 2015 to November 2020,with large atherosclerotic acute cerebral infarction(Non-lacunar cerebral infarction align with TOAST classification of large atherosclerotic type and single lobe infarct area> 2×1 cm or involving more than 2 lobe),who hospitalized at the967 th Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army.The data included general data,laboratory data and imaging data.Patients were divided into HT group and non-HT group according to whether they had hemorrhagic transformation.The statistical software(version SPSS17.0)was used to analyze the research data.The independent sample t test was used for the comparison between two groups of normal distribution measurement data,the rank sum test was used for the comparison between two groups of nonnormal distribution measurement data;the comparison between each group of count data was used χ2 test: Logistic regression test is performed on the factors that have differences in the results of t test,rank sum test,and χ2 test to determine the risk factors of HT.Perform multiple comparisons such as ROC curve analysis for statistically significant indicators,analyze the predictive ability of the indicator for HT,and determine its sensitivity and specificity.Research results: 311 patients with acute cerebral infarction(atherosclerosis)were included in this study.251 patients(80.71%)without hemorrhagic transformation,including 161 male patients(61.4%)and 90 female patients(35.8%).The average age was 68.85 ±12.05 years old.The other 60 patients(19.29%)were with hemorrhagic transformation,including 37 male patients(61.6%)and 23 female patients(38.4%).The average age was 71.97 ±10.97 years old.29 indexes were included in univariate analysis,such as NIHSS score,smoking and drinking history,blood pressure,blood sugar,total cholesterol,triglyceride and TG/HDL-C.The following 4 points were founded through analysis: 1.There was no significant statistical significance(P>0.05)between patients in HT group and non-HT group in age,sex,systolic and diastolic blood pressure at admission,hypertension,diabetes,coronary heart disease,stroke,cerebral hemorrhage,antithrombotic drug use,smoking,blood sugar,C-reactive protein,platelet count,glycosylated hemoglobin,uric acid,urea nitrogen,creatinine,total cholesterol,troponin I,and D-dimer.2.There were statistically significant(P< 0.05)between HT group and non-HT group in drinking history,NIHSS score,neutrophil percentage,triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),TG/HDL-C and international normalized ratio(INR).HDL-C,LDL-C,TG and TG/HDL-C may be potential protective factors of HT.NIHSS score,neutrophil percentage and INR may be the risk factors of HT.The higher the index,the higher the risk of HT.3.NIHSS score and HDL-C may be independent risk factors of HT.The higher NIHSS score and the lower HDL-C,the higher the risk of HT.There is no independent correlation between the occurrence of HT and the percentage of neutrophils,TG,LDL-C,INR,TG/HDL-C as well as drinking history.4.According to prodiction of NIHSS score,the sensitivity of HT is 46.7% and the specificity is 84.1%.According to prodiction of HDL-C the sensitivity of HT is 60% and the specificity is 66.5%.NIHSS score has certain specificity in predicting the occurrence of HT.Analysis conclusion:1.TG/HDL-C may be related to the hemorrhagic transformation of atherosclerotic cerebral infarction,and it is negatively related,that is,the higher TG/HDL-C is,may be the lower risk of HT.2.TG/HDL-C cannot be used as an independent risk factor to predict the occurrence of HT.3.The predictive ability of TG/HDL-C for HT may be worse than that of single lipid HDL-C.4.NIHSS score and HDL-C may be one of the independent risk factors of HT.The higher NIHSS score and the lower HDL-C,the higher the risk of HT.NIHSS score has certain specificity in predicting the occurrence of HT.5.LDL-C and TG may be one of the protective factors for HT.The higher LDL-C values are,the lower risk of HT will occur.Percentage of neutrophils and INR may be one of the risk factors for HT.The higher the indicator is,may be the higher risk of HT.