Predictive value of serum homocysteine level in bleeding transformation after alteplase thrombolytic therapy in acute ischemic stroke patients
Objective:To investigate the predictive value of serum homocysteine(Hcy)in bleeding transformation after alteplase thrombolytic therapy in acute ischemic stroke patients.Methods:From January 2020 to December 2022,190 patients with acute ischemic stroke who underwent alteplase thrombolytic therapy were selected as the study objects.All patients were treated with alteplase thrombolytic therapy.Head CT/MRI was periodically reviewed within 24h after thrombolytic therapy to evaluate the occurrence of bleeding transformation.Patients with hemorrhage transformation after thrombolysis were included in the occurrence group,and those without hemorrhage transformation were included in the non-occurrence group.Serum Hcy levels were detected before thrombolytic therapy.The baseline data questionnaire was designed,and the baseline data of the two groups were analyzed and compared.To analyze the influencing factors of hemorrhage transformation in patients with acute ischemic stroke after alteplase thrombolytic therapy.Receiver operating curve(ROC)was plotted to analyze the predictive value of serum Hcy level before treatment in bleeding transformation after alteplase thrombolytic therapy in acute ischemic stroke patients.Results:The incidence of hemorrhage transformation after thrombolytic therapy was 21.58%in 190 patients.There were significant differences in NIHSS score,serum Hcy before treatment,atrial fibrillation and 24h systolic blood pressure after thrombolysis between the patients and the non-patients(P<0.05).Logistic regression analysis showed that high NIHSS score at admission,atrial fibrillation,high systolic blood pressure 24h after thrombolytic therapy,and high serum Hcy level were risk factors for bleeding transformation after alteplase thrombolytic therapy(OR>1,P<0.05).Receiver operating curve(ROC)was plotted,and the results showed that the AUC of serum Hcy level before treatment in predicting the risk of bleeding conversion after alteplase thrombolytic therapy in patients with acute ischemic stroke was 0.862.When the cut-off value was 16.460(μmol/L),the sensitivity and specificity were 0.780 and 0.846,respectively.Conclusion:Serum Hcy level is closely related to the occurrence of hemorrhage transformation after alteplase thrombolytic therapy in patients with acute ischemic stroke,and its high expression indicates that patients with acute ischemic stroke have a higher risk of hemorrhage transformation after alteplase thrombolytic therapy.
万方数据
维普
