Zhu Lin, Jiang Fuping, Wang Meng, Zhai Qian, Zhang Qing, Wang Feng, Mao Xuqiang, Chen Nihong, Zhou Junshan, Xi Guangjun, Shi Yachen
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Front Neurosci. 2022 Jan 25;15:808436. doi: 10.3389/fnins.2021.808436. eCollection 2021.
Fluid-attenuated inversion recovery vascular hyperintensity (FVH) can reflect the collateral status, which may be a valuable indicator to predict the functional outcome of acute stroke (AS) patients.
A total of 190 AS patients with large vessel occlusion (LVO) were retrospectively investigated. All patients completed a 6-month follow-up and their modified Rankin Scale (mRS) scores were recorded at 1, 3, and 6 months after intravenous thrombolysis (IVT). Based on their mRS at 3 months, patients were divided into two groups: poor prognosis (131 patients; 68.9% of all subjects) and favorable prognosis (59 patients; 31.1% of all subjects). The death records of 28 patients were also analyzed in the poor prognosis group.
(1) Univariate and multivariate analyses showed that the higher National Institutes of Health Stroke Scale (NIHSS) score at admission, higher fasting blood glucose, and lower FVH score were independent risk factors to predict the poor prognosis of IVT. (2) Survival analysis indicated that FVH score was the only baseline factor to predict the 6-month survival after IVT. (3) Baseline FVH score had great prediction performance for the prognosis of IVT (area under the curve = 0.853). (4) Baseline FVH score were negatively correlated with the NIHSS score at discharge and mRS score at 1, 3, and 6 months.
Among various baseline clinical factors, only the FVH score might have implications for 3-month outcome and 6-month survival of AS patients after IVT. Baseline FVH score showed great potential to predict the prognosis of the AS patients.
液体衰减反转恢复血管高信号（FVH）可反映侧支循环状态，这可能是预测急性卒中（AS）患者功能预后的一个有价值指标。
回顾性研究了190例伴有大血管闭塞（LVO）的AS患者。所有患者均完成了6个月的随访，并记录了静脉溶栓（IVT）后1、3和6个月时的改良Rankin量表（mRS）评分。根据患者3个月时的mRS评分，将其分为两组：预后不良组（131例患者；占所有受试者的68.9%）和预后良好组（59例患者；占所有受试者的31.1%）。还分析了预后不良组中28例患者的死亡记录。
（1）单因素和多因素分析显示，入院时较高的美国国立卫生研究院卒中量表（NIHSS）评分、较高的空腹血糖和较低的FVH评分是预测IVT预后不良的独立危险因素。（2）生存分析表明，FVH评分是预测IVT后6个月生存的唯一基线因素。（3）基线FVH评分对IVT预后具有良好的预测性能（曲线下面积=0.853）。（4）基线FVH评分与出院时的NIHSS评分以及1、3和6个月时的mRS评分呈负相关。
在各种基线临床因素中，只有FVH评分可能对AS患者IVT后的3个月结局和6个月生存有影响。基线FVH评分显示出预测AS患者预后的巨大潜力。
