Objective To explore the risk factors of hemorrhagic transformation (HT) following defibrase therapy in patients with acute cerebral infarction.Methods The clinical data of 245 patients with acute cerebral infarction,admitted to and treated with batroxobin in our hospital from March 2011 to May 2015,were summarized retrospectively.According to the intracranial hemorrhage under hospital CT scan or MRI,these patients were divided into HT group (n=18) and non-HT group (n=227).Influencing factors were analyzed by stepwise Logistic regression.The receiver operating characteristic (ROC) curve analysis on the independent risk factors was performed to obtain the optimum predictive value of HT following defibrase therapy.Results National Institutes of Health Stroke Scale (NIHSS) scores,sizes of cardioembolism,massive hemispheric infarction and cortical infarction,and fasting blood glucose level were statistically significant between HT and non-HT groups (P＜0.05).Logistic regression analysis demonstrated that NIHSS scores (OR=1.262,95％ CI=1.025-1.554,P=0.028) and size of cardioembolism (OR=3.949,95％CI=1.093-14.269,P=0.036) were independent predictors of HT following defibrase therapy in patients with acute cerebral infarction.The ROC curve showed that the optimal cutoffpoint of NIHSS scores to predict HT was 14.Conclusion Risk factors associated with HT following defibrase therapy in patients with acute cerebral infarction include high NIHSS scores and cardioembolism.

Objective:To investigate the correlation between 24 h blood pressure variability and early neurological improvement (ENI) in patients with large vessel occlusion (LVO) after endovascular thrombectomy (ET).Methods:Patients with LVO received ET in the Emergency Department, the Affiliated Hospital of Nantong University from January 2012 to February 2018 were enrolled retrospectively. During the first 24 h after ET, the blood pressure was recorded every 2 h, and blood pressure variability was evaluated by standard deviation (SD) and successive variation (SV). At 24 h after ET, the National Institutes of Health Stroke Scale (NIHSS) score was evaluated again. The re-evaluation of 0 point or a decrease of ≥4 from the baseline score was defined as ENI. Multivariate logistic regression analysis was used to evaluate the relationship between blood pressure variability and ENI. Results:A total of 74 patients with LVO received ET were enrolled, of which 39 (52.7%) had ENI. Univariate analysis showed that the proportion of patients with good recanalization in the ENI group after procedure were significantly higher than that in the non-ENI group ( P<0.05), while the average systolic blood pressure, average diastolic blood pressure, systolic blood pressure variability (SBPV) -SD and SBPV-SV within 24 h after ET and baseline total cholesterol level were significantly lower than those in the non-ENI group (all P<0.05). Multivariate logistic regression analysis showed that higher SBPV-SV was an independent risk factor for non-ENI (odds ratio 1.223, 95% confidence interval 1.038-1.440; P=0.016). Conclusion:Higher SBPV-SV after ET is associated with poor early neurological improvement in patients with LVO, and it is expected to be a potential target for blood pressure management in patients after ET.