Objective To investigate the relationship between serum matrix metalloproteinase(MMP)-9,peroxi-some proliferator-activated receptor γ(PPARγ)levels and hemorrhagic transformation(HT)after non-thrombolytic therapy in patients with acute cerebral infarction(ACI).Methods 193 patients with ACI admitted to Neurology De-partment of the 920th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China hospital from July 2020 to June 2023 were prospectively screened.According to the imaging findings,the patients could be divid-ed into HT group(n=39)and non-HT group(n=154).Serum MMP-9 and PPAR-9 levels and general data of the two groups were compared.Logistic regression model was used to analyze the risk factors affecting the occurrence of HT in ACI patients after non-thrombolytic therapy,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum PPAR-9 and MMP-9 in the occurrence of HT in ACI patients after non-thrombolytic ther-apy.Results Compared with non-HT group,serum PPARγ level in HT group was lower and MMP-9 level was higher,and the difference was statistically significant(P＜0.05).The National Institutes of Health Stroke Scale(NIHSS)score,the proportion of diabetes mellitus,the history of atrial fibrillation,the time from onset to treatment and the lev-els of HbA1c,low density lipoprotein cholesterol(LDLC)and hypersensitive C-reactive protein(hs-CPR)in the HT group were higher than those in the non-HT group.The difference was statistically significant(P＜0.05).Multivariate Logistic regression model showed that history of atrial fibrillation,high levels of hs-CRP and MMP-9 were independent risk factors for HT after non-thrombolytic therapy in ACI patients,while high levels of PPARγ were protective factors for HT(P＜0.05).ROC curve showed that serum PPARγ and MMP-9 independently predicted the AUC of HT after ACI non-thrombolytic therapy was 0.787 and 0.737.log(P)method was used to combine PPARγ and MMP-9.The AUC(95％CI)of the combined prediction was 0.898(0.846～0.937),and the efficiency of the combined prediction was better than that of the single prediction(P＜0.05).Conclusion The high level of MMP-9 is an independent risk factor for HT after non-thrombolytic treatment in ACI patients,and the high level of PPARγ is a protective factor for HT af-ter non-thrombolytic treatment in ACI patients.The combined prediction of HT after non-thrombolytic treatment in ACI patients is of high clinical value.
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