Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang 330209, China; Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China.
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China.
Clin Neurol Neurosurg. 2024 Feb;237:108126. doi: 10.1016/j.clineuro.2024.108126. Epub 2024 Jan 19.
Elevated level of D-Dimer often indicates a worse prognosis in cerebral infarction. However, there is limited research on this impact within recent small subcortical infarction (RSSI). We aim to explore the role of inflammation and the total magnetic resonance imaging (MRI) burden of cerebral small vessel disease (cSVD) in this process.
384 RSSI patients and 189 matched healthy controls were strictly registered in the current research. We evaluated short-term and long-term outcomes by measuring the percentage of the National Institutes of Health Stroke Scale (NIHSS) improvement and the modified Rankin Scale (mRS) at 3 months, respectively. We also assessed the chronic, sustained brain damage associated with cSVD using the total MRI burden and confirmed the relationship between prognosis and the total MRI burden of cSVD. Furthermore, we explored the associations between D-dimer and C-reactive protein (CRP) levels with NIHSS improvement and mRS at 3 months, as well as their relationships with both the total MRI burden of cSVD and its 4 imaging features.
Both NIHSS improvement and the mRS at 3 months were found to be correlated with the total MRI burden of cSVD. Higher D-dimer and CRP levels showed a linear correlation, indicating worse prognosis and a higher total MRI burden of cSVD. The four imaging features of the total MRI burden of cSVD did not exhibit entirely consistent patterns when exploring their correlations with prognosis and laboratory indicators.
Inflammation-associated D-dimer predicts neurological outcomes in patients with recent small subcortical infarct, and reflects a more severe total MRI burden of cSVD.
D-二聚体水平升高通常表明脑梗死预后较差。然而，在最近的小皮质下梗死（RSSI）中，对此影响的研究有限。我们旨在探讨炎症和脑小血管病（cSVD）总磁共振成像（MRI）负担在这一过程中的作用。
本研究严格登记了 384 例 RSSI 患者和 189 例匹配的健康对照者。我们通过测量 NIHSS 改善百分比和 3 个月时改良 Rankin 量表（mRS）来评估短期和长期结局。我们还使用总 MRI 负担评估与 cSVD 相关的慢性、持续脑损伤，并证实预后与 cSVD 总 MRI 负担之间的关系。此外，我们探讨了 D-二聚体和 C 反应蛋白（CRP）水平与 NIHSS 改善和 3 个月时 mRS 的关系，以及它们与 cSVD 总 MRI 负担及其 4 种影像学特征的关系。
NIHSS 改善和 3 个月时的 mRS 均与 cSVD 总 MRI 负担相关。较高的 D-二聚体和 CRP 水平呈线性相关，表明预后较差且 cSVD 总 MRI 负担较高。在探讨 cSVD 总 MRI 负担的 4 种影像学特征与预后和实验室指标的相关性时，它们并未呈现完全一致的模式。
炎症相关的 D-二聚体预测近期小皮质下梗死患者的神经结局，并反映出更严重的 cSVD 总 MRI 负担。
