Objects

In this study, we investigated the association between plasma total homocysteine(tHcy) levels and the risk of early hemorrhagic transformation(HT) in patients with acute ischemic stroke(AIS).

Methods

Consecutive hospitalized participants who met the inclusion criteria were enrolled and grouped according to plasma tHcy levels. Participants were divided into a low homocysteine level(L-tHcy) group (<12 µmol/L) and a high homocysteine level group(H-tHcy) (≥ 12 µmol/L). Baseline computed tomography (CT) examination was performed. HT was determined via CT or magnetic resonance imaging within 1 to 3 days after admission.

Results

A total of 1858 patients were screened and 1378 patients completed the this study(797 patients in the H-tHcy group and 581 patients in the L-tHcy group). HT incidence was 5.2% (30/581,) in the L-tHcy group and 11.2% (90/797) in the H-tHcy group(P<0.05). Binary logistic regression analysis showed that initial NIHSS score, tHcy levels, treatment with recombinant tissue plasminogen activator thrombolysis, systolic blood pressure on admission, glucose level on admission, smoking status and estimated glomerular filtration rate were independent risk factors for HT. Receiver operating characteristic analysis showed that tHcy level was a moderately sensitive and specific index to predict the incidence of HT, and the optimal cutoff was 16.56 μmol/L (sensitivity 63.3%, specificity 41.3%).

Conclusion

Our study findings reveal that high plasma tHcy level is one independent risk factor associated with increased risk of early HT in patients with AIS.

中文翻译：

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血浆总同型半胱氨酸水平与急性缺血性卒中患者早期出血转化风险之间的关联：基于医院的研究

对象

在这项研究中，我们调查了急性缺血性脑卒中（AIS）患者血浆总同型半胱氨酸（tHcy）水平与早期出血性转化（HT）风险之间的关系。

方法

符合入组标准的连续住院患者入组，并根据血浆tHcy水平分组。参加者分为低同型半胱氨酸水平（L-tHcy）组（<12 µmol / L）和高同型半胱氨酸水平组（H-tHcy）（≥12 µmol / L）。进行了基线计算机断层扫描（CT）检查。入院后1至3天内通过CT或磁共振成像确定HT。

结果

总共筛选了1858例患者，完成了本研究的1378例患者（H-tHcy组为797例，L-tHcy组为581例）。L-tHcy组的HT发生率为5.2％（30/581，），H-tHcy组的HT发生率为11.2％（90/797）（P <0.05）。二进制logistic回归分析显示，初始NIHSS评分，tHcy水平，重组组织纤溶酶原激活物溶栓治疗，入院时收缩压，入院时血糖水平，吸烟状况和估计的肾小球滤过率是HT的独立危险因素。接受者操作特征分析表明，tHcy水平是预测HT发生率的中度敏感度和特异性指标，最佳临界值为16.56μmol/ L（敏感性为63.3％，特异性为41.3％）。

结论

我们的研究结果表明，血浆tHcy水平高是与AIS患者早期HT风险增加相关的独立危险因素。