Relationship Between the Degree of Leukoaraiosis Before Intravenous Thrombolysis and Postoperative HT,Short-term Prognosis in AIS Patients
Objective To investigate the effect of leukoaraiosis before intravenous thrombolysis on postoperative hemorrhagic transformation(HT)and short-term prognosis in patients with acute ischemic stroke(AIS).Methods A total of 288 AIS patients who underwent intravenous thrombolysis in our hospital from January 2016 to December 2021 were included.According to the occurrence of HT and prognosis,they were divided into HT group(242 patients)and non-HT group(46 patients),good prognosis group(166 patients)and poor prognosis group(122 patients).The clinical characteristics of HT group and non-HT group,good prognosis group and poor prognosis group were compared,and the relationship between postoperative HT,poor prognosis at 90 days and the degree of leukoaraiosis before intravenous thrombolysis was evaluated.Results There were significant differences in the proportion of patients with moderate to severe leukoaraiosis,D-dimer(D-D)level and urine specific gravity level between the HT group and the non-HT group(P<0.05).There were statistically significant differences in age,baseline National Institutes of Health Stroke Scale(NIHSS)score,HT ratio,baseline random blood glucose level,international normalized ratio(INR),acute stroke treatment Org10172 test(TOAST)classification,D-D,fibrinogen(FIB),prothrombin time(PT)and urine glucose positive ratio between the poor prognosis group and the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that moderate to severe leukoaraiosis and D-D level were independent influencing factors of HT in AIS patients after intravenous thrombolysis(P<0.05).Baseline NIHSS score and white blood cell count(WBC)were independent influencing factors of poor prognosis at 90 days after intravenous thrombolysis in AIS patients(P<0.05).Conclusion Whether HT after intravenous thrombolysis in AIS patients is closely related to moderate to severe leukoaraiosis and D-D level.In addition,patients with high baseline NIHSS score and high WBC count often indicate poor short-term prognosis.