Clinical Research About Using Antiplatelet After Spontaneous Hemorrhagic Transformation Of Acute Cerebral Infarction

Objective:To analyze the effect of using antiplatelet aggregation drugs on the short-term clinical prognosis after spontaneous hemorrhagic transformation(HT)of acute cerebral infarction.Methods:Three hundred and eighty-six patients with spontaneous hemorrhagic transformation of acute cerebral infarction admitted to the Second Hospital of Hebei Medical University from December 2013 to December 2019 were retrospectively collected.HT cases were divided into type HI-1,type HI-2,type PH-1,type PH-2 according to ECASS study,and were divided into antiplatelet group and non-antiplatelet group according to whether using antiplatelet aggregation drugs or not.The clinical data were collected and compared between them.Patients with increased NIHSS scores,worsening symptoms,or death at discharge or at 1 month after HT were considered as neurological deterioration.A decrease in the NIHSS score of less than 18%was considered no changed,and decrease of more than 18%was considered improvement.Results:Type HI-2 had a higher short-term clinical improvement rate than type HI-1[52.1%(75/150)vs.37.3%(56/144),?~2=6.470,P=0.011].The group which continued use of antiplatelet aggregation drugs had better short-term clinical outcomes in type HI[neurological deterioration,no change,improvement:1.1%(2/189),49.7%(94/18),49.2%(93/189)vs.6.7%(7/105),57.1%(60/105),36.2%(38/105),Z=-2.550,P=0.011].Multivariate Logistic regression analysis on patients with type HI showed that those who continued to use antiplatelet aggregation drugs after HT had an increased short-term clinical improvement rate(OR=1.919,95%CI:1.158?3.181).For type HI-1,the short-term clinical improvement rate increased(OR=2.014,95%CI:1.248?3.250).Conclusions:For the spontaneous hemorrhagic transformation of acute cerebral infarction,type HI-2 had a higher short-term clinical improvement rate than type HI-1.Using of antiplatelet aggregation drugs after HT was safe and effective for Type HI(whether HI-1 or HI-2),and it was beneficial to the improvement of clinical short-term neurological function.