Study On Risk Factors Related To Hemorrhage Transformation And Prognosis In Patients With Acute Ischemic Stroke After Thrombolysis

Objective: To analyze the risk factors related to hemorrhagic transformation(HT)and prognosis of patients with acute ischemic stroke(AIS)after recombinant tissue plasminogen activator(rt PA)therapy.Methods:Patients who were diagnosed with AIS and received rt PA therapy in the Department of Neurology of the Second Hospital of Hebei Medical University from January 2019 to November 2019 were included in this study.The venous blood of the patients was collected before thrombolysis for blood routine examination.24 hours after thrombolysis,cranial CT examination was performed.National Institute of Health Stroke Scale(NIHSS)score was performed before thrombolysis and on the 7th day after onset,and Modified Rankin Scale(m RS)score was performed before thrombolysis and 3 months after onset.Further statistical analysis of the relationship between various factors and HT and prognosis.Results: 1.A total of 91 patients were included in this study,including 24 females.There were 24 cases with HT,43 cases had a good prognosis on the 7th day after rt PA treatment,and 53 cases had a good prognosis after 3 months.2.There was a linear positive correlation between the NIHSS score before thrombolysis and short-term prognosis(r = 0.448,P < 0.001).3.There was a positive linear correlation between atrial fibrillation and HT(r = 0.348,P = 0.001).4.Gender(OR=4.043,95%CI1.422-1.495,P=0.009)and NIHSS score before thrombolysis(OR=1.122,95%CI1.036-1.215,P=0.004)were independent risk factors for long-term prognosis.5.There was no significant correlation between lymphocyte count and the ratio of lymphocyte to monocyte with HT and prognosis.6.There was no significant correlation between the eosinophils and HT and prognosis.Conclusion:1.The neurological deficit before rt PA thrombolysis in patients with AIS is the main factor affecting the short-term and long-term prognosis.2.Atrial fibrillation can increase the risk of HT in patients with AIS after rt PA thrombolytic therapy.3.Female patients with AIS are at high risk of poor long-term prognosis after intravenous rt PA thrombolytic therapy.4.Lower lymphocyte count and low lymphocyte-to-monocyte ratio did not significantly increase the risk of HT and poor prognosis.5.Lower eosinophils did not significantly increase the risk of HT and poor prognosis.