Effect of Shuxuetong Injection on Hemorrhagic Transformation in Patients with Acute Ischemic Stroke After Revascularization:A Retrospective Cohort Study
10.13359/j.cnki.gzxbtcm.2025.07.008
- VernacularTitle:疏血通注射液对急性缺血性卒中血管再通患者出血转化影响的回顾性队列研究
- Author:
Haoxuan CHEN
1
;
Hao LIN
;
Yuanqi ZHAO
;
Min ZHAO
Author Information
1. 广东省中医院珠海医院,广东 珠海 519015
- Keywords:
acute ischemic stroke;
hemorrhagic transformation;
revascularization;
breaking blood and resolving stasis;
Shuxuetong Injection;
safety
- From:
Journal of Guangzhou University of Traditional Chinese Medicine
2025;42(7):1603-1610
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of Shuxuetong Injection,which is a Chinese patent drug with the blood-breaking and stasis-resolving actions and is administered within 24 hours after revascularization,on hemorrhagic transformation(HT)in patients with acute ischemic stroke(AIS).Methods The retrospective study was carried out in 204 AIS patients who received revascularization treatment such as intravenous thrombolysis,mechanical thrombectomy,or bridging therapy at the Encephalopathy Center of Guangdong Provincial Hospital of Chinese Medicine between January 1,2018,and April 30,2021.The patients were divided into Shuxuetong group(57 cases,receiving Shuxuetong injection within 24 hours after revascularization)and the non-Shuxuetong group(147 cases,having no Shuxuetong injection within 24 hours revascularization).With HT incidence as the primary outcome,Logistic regression analysis was performed to explore the correlation between Shuxuetong use and HT,and the results were expressed as odds ratios(OR)and 95%confidence intervals(CIs).Results(1)There were 6 cases of HT(10.53%)in the Shuxuetong group and 33 cases of HT(22.45%)in the non-Shuxuetong group.The Shuxuetong group tended to have a lower HT incidence,though the difference was not statistically significant(P=0.052).(2)The Shuxuetong group had a younger age,lower baseline National Institutes of Health Stroke Scale(NIHSS)scores,white blood cell count(WBC)and international normalized ratio(INR),longer onset-to-needle time(ONT)and onset-to-puncture time(OPT),higher percentage of using intravenous thrombolysis,and lower percentage of prior anticoagulant use than the non-Shuxuetong group when admitted to the hospital(all P＜0.05).(3)Patients were divided into HT group(39 cases,19.12%)and non-HT group(165 cases,80.88%)according to the occurrence of HT.Shuxuetong use was less frequent in the HT group(6 cases,15.38%)than that in the non-HT group(51 cases,30.91%),but the difference was not significant(P=0.052).Intravenous thrombolysis was less common in the HT group(4 cases,10.26%)than that in the non-HT group(53 cases,32.12%),and the difference was significant(P＜0.05).(4)Univariate analysis(Model 1)showed that non-users of Shuxuetong within 24 hours had 2.46-fold higher HT risk than the users[95%CI(0.970-6.239),P=0.058].In the multivariate logistic regression analysis(Model 2),adjustment was conducted for HT-related confounders of age,sex,intravenous thrombolysis,baseline NIHSS score,atrial fibrillation,prior antiplatelet/anticoagulant use,admission systolic/diastolic blood pressure,diabetes,24-hour antiplatelet/anticoagulation treatment.Model 2 analysis revealed that non-users of Shuxuetong within 24 hours had 3.17-fold higher HT risk than the users[95%CI(1.061-9.456),P=0.039].Conclusion Among AIS patients receiving revascularization treatment such as intravenous thrombolysis,mechanical thrombectomy,or bridging therapy therapies,administration of Shuxuetong Injection within 24 hours does not increase HT risk.
