T2WI-FLAIR脑白质高信号与脑梗死机械取栓治疗预后的相关性

Correlation between T2WI-FLAIR white-matter hypersignal and prognosis of mechanical thrombectomy for cerebral infarction

目的分析T2WI-FLAIR脑白质高信号与脑梗死机械取栓治疗患者预后的相关性。方法选取2021-03—2023-01于喀什地区第一人民医院卒中中心接受机械取栓治疗的100例脑梗死患者为研究对象。随访3个月后,根据mRS评分分为预后良好组(n=59例)和预后不良组(n=41例)。采用单因素与多因素Logistic回归分析影响脑梗死机械取栓治疗预后的相关因素,采用预测模型受试者工作特征(ROC)曲线与曲线下面积(AUC)分析评估效能。结果单因素分析显示,预后良好组患者的年龄、发病到医院就诊时间、发病2周NIHSS评分、Fazekas脑白质高信号评分均低于预后不良组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄≥60岁、发病到医院就诊时间≥6 h、发病2周NIHSS评分≥12.5分、Fazekas脑白质高信号评分≥3分是影响脑梗死机械取栓患者预后的独立危险因素,差异有统计学意义(P<0.05)。Fazekas脑白质高信号评分预测脑梗死机械取栓患者预后的ROC曲线AUC值为0.882。结论T2WI-FLAIR脑白质高信号与脑梗死机械取栓治疗患者的预后密切相关,可作为预测脑梗死机械取栓治疗患者预后的重要指标,同时也要综合考虑年龄、发病到医院就诊时间、神经功能缺损程度等多种因素,从而为临床诊断和治疗提供更有价值的参考。

Objective To analyze the correlation between T2WI-FLAIR cerebral white matter high signal and the prognosis of patients treated by mechanical thrombolysis for cerebral infarction.Methods One hundred patients with cerebral infarction undergoing mechanical thrombectomy in the Stroke Center of the First People’s Hospital of Kashgar Region from March 2021 to January 2023 were selected.After 3 months of follow-up,they were divided into good prognosis(n=59)and poor prognosis(n=41).Univariate and multivariate Logistic regression were used to analyze the prognosis of mechanical thrombectomy for cerebral infarction.Efficacy was assessed using the receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results Univariate analysis showed that age of the patients,the time of onset to hospital,NIHSS score at 2 weeks,and Fazekas white matter hyperintensity score were all lower than those of the poor prognosis group,with significant differences(P<0.05).Multivariate Logistic regression analysis showed that≥60 years old,≥6 hours of onset to hospital treatment,NIHSS score≥12.5 at 2 weeks,and Fazekas score≥3 were independent risk factors affecting the prognosis of cerebral infarction patients with mechanical thrombectomy,with statistically significant differences(P<0.05).The ROC curve AUC of Fazekas white matter hyperintensity score for the prediction of cerebral infarction patients with mechanical thrombolysis was 0.882.Conclusion T2WI-FLAIR brain white matter hyperintensity is closely related to the prognosis of patients with mechanical removal of cerebral infarction,which can be used as an important index of cerebral infarction.Age,the time of onset to hospital,the degree of neurological deficiency also should be considered,so as to provide more valuable reference for clinical diagnosis and treatment.