Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
School of Mental Health, Wenzhou Medical University, Wenzhou, China.
Gerontology. 2023;69(5):571-580. doi: 10.1159/000528951. Epub 2023 Jan 5.
Hemorrhagic transformation (HT) is a severe but frequent complication of acute ischemic stroke (AIS). This study aimed to evaluate the relationship between serum lactate dehydrogenase (LDH) levels and HT.
We retrospectively included 542 AIS patients with HT and 1,091 age- and gender-matched patients without HT. Demographic and clinical data were obtained from medical records, and blood samples were obtained within 24 h after admission. The characteristics of the groups were compared. With the receiver operating characteristic (ROC) curve analysis, we assessed the discriminating capacity of LDH levels in predicting HT in patients with AIS. The logistic regression model was used to determine the connection between LDH and HT.
The HT group had considerably higher LDH levels than the non-HT group (263.0 [216.0-323.3] U/L versus 178.0 [162.0-195.0] U/L, p < 0.001). We also observed that the levels of LDH in the parenchymal hemorrhage subgroup were significantly higher than those in the hemorrhagic infarction subgroup (281.0 [230.0-340.0] U/L versus 258.0 [209.0-311.0] U/L, p < 0.001). The area under the ROC curve of LDH was 0.890 (95% confidence level [CI] 0.874-0.905, p < 0.001). Besides, logistic regression revealed that high LDH levels (LDH >215 U/L) showed a higher risk of HT (odds ratio = 10.958, 95% CI 7.964-15.078, p < 0.001).
High LDH levels were linked with an increased risk of HT in AIS patients. Practical measures should be considered in patients with increased LDH levels (LDH >215 U/L).
出血转化（HT）是急性缺血性脑卒中（AIS）的一种严重但常见的并发症。本研究旨在评估血清乳酸脱氢酶（LDH）水平与 HT 之间的关系。
我们回顾性纳入了 542 例伴有 HT 的 AIS 患者和 1091 例年龄和性别匹配的无 HT 患者。从病历中获取人口统计学和临床数据，并在入院后 24 小时内采集血液样本。比较两组的特征。通过受试者工作特征（ROC）曲线分析，评估 LDH 水平在预测 AIS 患者 HT 中的区分能力。使用逻辑回归模型确定 LDH 与 HT 之间的联系。
HT 组的 LDH 水平明显高于非 HT 组（263.0[216.0-323.3] U/L 比 178.0[162.0-195.0] U/L，p<0.001）。我们还观察到，实质出血亚组的 LDH 水平明显高于出血性梗死亚组（281.0[230.0-340.0] U/L 比 258.0[209.0-311.0] U/L，p<0.001）。LDH 的 ROC 曲线下面积为 0.890（95%置信区间[CI]0.874-0.905，p<0.001）。此外，逻辑回归显示，高 LDH 水平（LDH>215 U/L）与 HT 风险增加相关（优势比=10.958，95%CI7.964-15.078，p<0.001）。
高 LDH 水平与 AIS 患者 HT 风险增加相关。应考虑在 LDH 水平升高（LDH>215 U/L）的患者中采取实用措施。
