Abstract

Objective To investigate the correlation between cerebral microbleed （CMB） and hemorrhage transformation （HT） after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke. Methods The patients with acute cerebral infarction treated with intra-arterial urokinase were enrolled. They were divided into either an HT goup or a non-HT froup according to whether they had HT or not. Conventional MRI sequences, susceptibility-weighted imaging （SWI）, and CT scan were performed before procedure. CT or MRI was reexamined within 48 hours after procedure. The patients＇ demoffaphic data, vascular risk factors, and the SWI sequences showed the numbers of CMB were documented in detail and they were compared and analyzed. Results A total of 62 patients were included, 22 in HT group and 40 in non-HT group. Univariate analysis showed that the proportions of hypertension （81.8% vs. 57. 5%; X2 = 3. 125, P= 0. 048）, diabetes （63.6% vs. 40. 0% ; X2 = 4. 019, P = 0. 042）, smoking （72. 7% vs. 37. 5% ; X2 = 4. 971, P = 0. 030）, and presence of CMB （X2 = 5. 297, P = 0. 018） of patients in the HT group were sigaificantly higher than those inthe non-HT group. Multivariate logistic regression analysis showed that hypertension （odds ratio [ OR] 1.51, 95% confidence interval [ CI] 1. 102 - 2. 954; P = 0. 028）, diabetes （OR 1.48, 95% CI 1.09 - 2. 825; P = 0. 039）, and CMB （OR 1. 867, 95% CI 1. 103 -3. 158; P =0. 020） were the independent risk factors for HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke. Conclusions CMB was one of the independent risk factors for occurring HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke. Key words: Stroke; Brain Ischemia; Cerebral Hemorrhage; Thrombolytic Therapy; Urokinase-TypePlasminogen Activator; Maetic Resonance Imaging Risk Factors

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