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目的:探讨出血性转化（hemorrhagic transformation, HT）及其不同亚型对急性缺血性卒中（acute ischemic stroke, AIS）患者临床转归的影响。方法:回顾性纳入2018年1月至2021年1月河南省人民医院收治的发病24 h内的AIS患者。HT定义为AIS发病后7 d内CT复查发现的颅内出血，并参考欧洲急性卒中协作研究（European Cooperative Acute Stroke Study, ECASS）-Ⅱ分型标准进一步分为出血性梗死（hemorrhagic infarction, HI）和脑实质血肿（parenchymal hematoma, PH）。在发病后90 d时采用改良Rankin量表进行转归评价，0~2分定义为转归良好，3~5分定义为转归不良。应用多变量n logistic回归分析确定转归的独立影响因素。n 结果:共纳入822例患者，男性478例（58.2%），年龄（60.6±10.6）岁，基线美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale, NIHSS）评分中位数8分（四分位数间距6~12分）。282例（34.4%）发生HT，447例（54.4%）转归不良。多变量n logistic回归分析显示，PH-1[优势比（odds ratio, n OR）2.461，95%置信区间（confidence interval, n CI）1.285~4.712；n P=0.007]、PH-2（n OR 5.291，95% n CI 1.178~23.758；n P=0.030）、入院时血糖（n OR 1.063，95% n CI 1.018~1.109；n P =0.005）以及基线NIHSS评分（n OR 1.124，95% n CI 1.076~1.175；n P<0.001）是转归不良的独立影响因素。n 结论:不同HT亚型对AIS患者转归的影响有所不同，其中PH-1和PH-2是转归不良的独立危险因素。“,”Objective:To investigate the effect of hemorrhagic transformation (HT) and its different subtypes on the clinical outcome of patients with acute ischemic stroke (AIS).Methods:Patients with AIS within 24 h of onset treated in Henan Provincial People\'s Hospital from January 2018 to January 2021 were retrospectively enrolled. HT was defined as intracranial hemorrhage found by CT reexamination within 7 d after the onset of AIS, and further divided into hemorrhagic infarction (HI) and parenchymal hematoma (PH) according to the classification standard of European Cooperative Acute Stroke Study (ECASS)-Ⅱ. The modified Rankin Scale was used to evaluate the outcome at 90 d after onset. 0-2 was defined as good outcome and 3-5 were defined as poor outcome. Multivariaten logistic regression analysis was used to determine the independent influencing factors of the outcomes.n Results:A total of 822 patients were enrolled, including 478 males (58.2%), aged 60.6±10.6 years. The median score of the baseline National Institutes of Health Stroke Scale (NIHSS) was 8 (interquartile range: 6-12). Two hundred and eighty-two patients (34.4%) developed HT and 447 (54.4%) had poor outcomes. Multivariate n logistic regression analysis showed that PH-1 (odds ratio [n OR] 2.461, 95% confidence interval [n CI] 1.285-4.712; n P=0.007), PH-2 (n OR 5.291, 95% n CI 1.178-23.758; n P=0.030), blood glucose at admission (n OR 1.063, 95% n CI 1.018-1.109; n P=0.005) and baseline NIHSS score (n OR 1.124, 95% n CI 1.076-1.175; n P<0.001) were the independent influencing factors of the poor outcomes.n Conclusion:Different HT subtypes have different effects on the outcomes of patients with AIS, among which PH-1 and PH-2 are the independent risk factors for poor outcomes.