Department of Neurology, The first affiliated hospital of Harbin Medical University, Harbin, China.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231167849. doi: 10.1177/10760296231167849.
Hemorrhagic transformation (HT) is a common complication of intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS) and may lead to neurological deterioration. This article discusses whether monocyte count to high-density lipoprotein ratio (MHR) level is associated with HT in AIS patients. The clinical data of AIS patients who underwent rt-PA IVT treatment were continuously collected. According to whether HT occurred, patients were divided into HT group and non-HT group. Potential association between MHR and HT in different subtypes AIS was explored by using logistic regression. A total of 444 AIS patients were retrospective analyzed. The MHR level was lower in HT group compared with the non-HT group in all AIS patients (0.28 vs 0.36, = .031) and in large-artery atherosclerosis (LAA) type AIS patients (0.31 vs 0.37, = .032). Low MHR was independently related to HT (OR:0.035, 95%CI:0.003-0.390, = .006). Among all TOAST subtypes, low MHR was only independently associated with HT in patients of LAA-type AIS after adjusting for confounding factors (OR:0.01, 95%CI:0.00-0.62, = .031), with an optimal cut-off value of 0.41, sensitivity of 85.7%, and specificity of 43.1%. MHR was not correlated with SVO, VE, and CE subtype AIS. Low MHR may be an independent predictor of HT in patients with AIS and this conclusion only existed in LAA-type AIS.
出血转化（HT）是急性缺血性脑卒中（AIS）患者静脉溶栓（IVT）的常见并发症，可导致神经功能恶化。本文探讨了单核细胞/高密度脂蛋白比值（MHR）水平与 AIS 患者 HT 的关系。连续收集接受 rt-PA IVT 治疗的 AIS 患者的临床资料。根据是否发生 HT，将患者分为 HT 组和非 HT 组。采用逻辑回归探讨不同亚型 AIS 中 MHR 与 HT 的潜在相关性。回顾性分析了 444 例 AIS 患者。与非 HT 组相比，所有 AIS 患者（0.28 比 0.36， = .031）和大动脉粥样硬化（LAA）型 AIS 患者（0.31 比 0.37， = .032）的 HT 组 MHR 水平较低。低 MHR 与 HT 独立相关（OR：0.035，95%CI：0.003-0.390， = .006）。在所有 TOAST 亚型中，调整混杂因素后，低 MHR 仅与 LAA 型 AIS 患者的 HT 独立相关（OR：0.01，95%CI：0.00-0.62， = .031），最佳截断值为 0.41，敏感度为 85.7%，特异度为 43.1%。MHR 与 SVO、VE 和 CE 型 AIS 无关。低 MHR 可能是 AIS 患者 HT 的独立预测因子，这一结论仅存在于 LAA 型 AIS 中。
