Analysis of risk factors related to hemorrhagic transformation after rt-PA thrombolysis in patients with acute ischemic stroke
Objective:To investigate the risk factors of hemorrhagic transformation(HT)after thrombolytic therapy with recombinant tissue plasminogen activator(rt-PA)in patients with acute ischemic stroke(AIS).Methods:198 patients with AIS who received rt-PA thrombolytic therapy in our hospital from January 2020 to March 2023 were selected as the study objects.The baseline data of patients were collected,the incidence of HT in AIS patients after rt-PA thrombolysis was investigated,and the related risk factors were analyzed.Results:Of 198 AIS patients,HT occurred in 12 cases(6.06%)and HT did not occur in 186 cases(93.94%)after thrombolysis with rt-PA.Univariate analysis showed that age,diabetes mellitus,hypertension,atrial fibrillation,time from onset to thrombolysis,and NIHSS score before treatment were correlated with the occurrence of HT after rt-PA thrombolysis in AIS patients,with statistical differences(P<0.05).Gender,smoking history,drinking history and stroke site were not related to the occurrence of HT after rt-PA thrombolysis in AIS patients,and there was no statistical difference(P>0.05).Multivariate analysis showed that age≥70 years old,combined with diabetes mellitus,combined with hypertension,combined with atrial fibrillation,time from onset to thrombolysis≥3 hours,and National Institutes of Health Neurological deficit score(NIHSS)≥15 points before treatment were high risk factors for HT after rt-PA thrombolysis in AIS patients(P<0.05).Conclusion:The occurrence of HT after rt-PA thrombolysis in AIS patients is affected by age,diabetes mellitus,hypertension,atrial fibrillation,time from onset to thrombolysis and nerve function.
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