临床医学工程2025，Vol.32Issue(11)：1183-1187,5.DOI:10.3969/j.issn.1674-4659.2025.11.1183
多模态CT及临床特征对急性缺血性脑卒中患者静脉溶栓后出血转化的预测价值
Predictive Value of Multimodal CT and Clinical Features for Hemorrhagic Transformation after Intravenous Thrombolysis in Patients with Acute Is-chemic Stroke
摘要
Abstract
Objective To investigate the predictive value of multimodal CT and clinical features for hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods 156 AIS patients who received intravenous thrombolytic therapy at the Second Affiliated Hospital of Xiamen Medical College from January 2021 to December 2024 were retrospectively selected and divided into the hemorrhagic transformation group(18 cases)and the non-hemorrhagic transformation group(138 cases)based on whether there was hemorrhagic transformation within 24 hours after intravenous thrombolysis therapy.The multimodal CT examination parameters[hyperdense middle cerebral artery sign(HMCAS),cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TTP),time to peak blood flow(Tmax),permeability surface(PS)]and clinical data[gender,age,medical history(hypertension,diabetes,hyperlipidemia,hypokalemia,hypoproteinemia,hyperuricemia),national institutes of health stroke scale(NIHSS)score,laboratory indicators(D-dimer,platelet count,total cholesterol,triglyceride)]were compared between the two groups.Logistic regression analysis was used to identify factors influencing hemorrhagic transformation after intravenous thrombolysis in AIS patients.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of key multimodal CT parameters and clinical features for hemorrhagic transformation after intravenous thrombolysis in AIS patients.Results Compared with the non-hemorrhagic transformation group,the hemorrhagic transformation group had significantly lower CBV and CBF,and significantly higher proportions of HMCAS and PS,as well as age,proportion of diabetes,and NIHSS score(P<0.05).Logistic regression analysis showed that multimodal CT parameters(CBV,CBF,PS)and NIHSS score were influencing factors for hemorrhagic transformation after intravenous thrombolysis in AIS patients(P<0.05).ROC curve analysis showed that the combined prediction of CBV,CBF,PS,and NIHSS score for hemorrhagic transformation after intravenous thrombolysis in AIS patients achieved an area under the curve(AUC)of 0.912,which was higher than the predictive performance of each individual indicator.Conclusions The combination of key multimodal CT parameters and clinical features has high predictive efficacy for hemorrhagic transformation after intravenous thrombolysis in AIS patients,and close attention should be paid in clinical practice.关键词
多模态CT/临床特征/急性缺血性脑卒中/静脉溶栓/预测价值Key words
Multimodal CT/Clinical feature/Acute ischemic stroke/Intravenous thrombolysis/Predictive value分类
临床医学引用本文复制引用
王艳微,朱柳红,朱福禄,王则托,陈文佳,成启华..多模态CT及临床特征对急性缺血性脑卒中患者静脉溶栓后出血转化的预测价值[J].临床医学工程,2025,32(11):1183-1187,5.基金项目
福建省自然科学基金计划项目(2025J011459) （2025J011459）
