Chen Jiahao, Chen Yiting, Lin Yisi, Long Jingfang, Chen Yufeng, He Jincai, Huang Guiqian
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
School of Foreign Language Studies, Wenzhou Medical University, Wenzhou 325000, China.
J Clin Med. 2023 Feb 12;12(4):1471. doi: 10.3390/jcm12041471.
Hemorrhagic transformation (HT) is a severe complication in patients with acute ischemic stroke (AIS). This study was performed to explore and validate the relation between bilirubin levels and spontaneous HT (sHT) and HT after mechanical thrombectomy (tHT).
The study population consisted of 408 consecutive AIS patients with HT and age- and sex-matched patients without HT. All patients were divided into quartiles according to total bilirubin (TBIL) level. HT was classified as hemorrhagic infarction (HI) and parenchymal hematoma (PH) based on radiographic data.
In this study, the baseline TBIL levels were significantly higher in the HT than non-HT patients in both cohorts ( < 0.001). Furthermore, the severity of HT increased with increasing TBIL levels ( < 0.001) in sHT and tHT cohorts. The highest quartile of TBIL was associated with HT in sHT and tHT cohorts (sHT cohort: OR = 3.924 (2.051-7.505), < 0.001; tHT cohort: OR = 3.557 (1.662-7.611), = 0.006).
Our results suggest that an increased TBIL is associated with a high risk of patients with sHT and tHT, and that TBIL is more suitable as a predictor for sHT than tHT. These findings may help to identify patients susceptible to different types and severity of HT.
出血性转化（HT）是急性缺血性卒中（AIS）患者的一种严重并发症。本研究旨在探讨并验证胆红素水平与自发性出血性转化（sHT）以及机械取栓术后出血性转化（tHT）之间的关系。
研究人群包括408例连续发生HT的AIS患者以及年龄和性别匹配的无HT患者。所有患者根据总胆红素（TBIL）水平分为四分位数。根据影像学数据，HT分为出血性梗死（HI）和脑实质血肿（PH）。
在本研究中，两个队列中HT患者的基线TBIL水平均显著高于非HT患者（<0.001）。此外，在sHT和tHT队列中，HT的严重程度随TBIL水平升高而增加（<0.001）。TBIL最高四分位数与sHT和tHT队列中的HT相关（sHT队列：OR = 3.924（2.051 - 7.505），<0.001；tHT队列：OR = 3.557（1.662 - 7.611），= 0.006）。
我们的结果表明，TBIL升高与sHT和tHT患者的高风险相关，并且TBIL作为sHT的预测指标比tHT更合适。这些发现可能有助于识别易发生不同类型和严重程度HT的患者。
