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不同动脉粥样硬化性卒中模式下神经功能恶化风险与临床结局的比较。

The comparison of the risk of neurological deterioration and clinical outcomes in different atherosclerotic stroke patterns.

作者信息

He Yue, Zhang Tingting, Wu Wenqi, Niu Kai, Cai Zhirong, Zhao Tian, Shao Yuanwei, Yang Yi, Zhu Ying, Yu Ming

机构信息

Neurology Department of Affiliated Hospital of Jiangsu University, No. 438 Jiefang Road, Zhenjiang, Jiangsu, China.

Radiology Department of Affiliated Hospital of Jiangsu University, Zhenjiang, China.

出版信息

Sci Rep. 2024 Dec 28;14(1):31359. doi: 10.1038/s41598-024-82862-1.

Abstract

This study aims to compare the incidences of neurological deterioration (ND) and poor outcome (a modified Ranking scale > 2 points at discharge) among patients with different atherosclerotic stroke patterns. A total of 688 participants were categorized into 4 groups according to atherosclerotic stroke pattern: multiple small infarcts (MSI), single subcortical infarction (SSI), borderzone infarct (BZI) and large infarct groups. Among the 4 groups, MSI group had the lowest incidences of ND and poor outcome (13.5% and 16.2%, respectively). In multivariable analyses, for BZI patients, the risks of ND [odds ratio (OR) = 3.90, 95% confidence interval (CI) = 2.10-7.22, p < 0.001] and poor outcome (OR = 3.45, 95% CI = 1.67-7.14, p = 0.001) both significantly increased compared to MSI, both of which were the highest among the 4 stroke patterns. The neutrophil to lymphocyte ratio in BZI and large infarct groups were higher than in MSI and SSI groups [3.35 (2.28, 5.04) and 3.36 (2.53, 4.94) vs. 2.64 (1.89, 4.06) and 2.71 (1.93, 3.91), p < 0.001]. BZI group had the highest risks of ND and poor outcome among atherosclerotic stroke patients. BZI and large infarct patients had stronger poststroke inflammation than MSI and SSI patients.

摘要

本研究旨在比较不同动脉粥样硬化性卒中模式患者的神经功能恶化(ND)发生率和不良预后(出院时改良Rankin量表评分>2分)情况。共有688名参与者根据动脉粥样硬化性卒中模式分为4组:多发性小梗死(MSI)、单发性皮质下梗死(SSI)、边缘带梗死(BZI)和大面积梗死组。在这4组中,MSI组的ND发生率和不良预后发生率最低(分别为13.5%和16.2%)。在多变量分析中,对于BZI患者,与MSI相比,ND风险[比值比(OR)=3.90,95%置信区间(CI)=2.10 - 7.22,p<0.001]和不良预后风险(OR = 3.45,95%CI = 1.67 - 7.14,p = 0.001)均显著增加,这两者在4种卒中模式中都是最高的。BZI组和大面积梗死组的中性粒细胞与淋巴细胞比值高于MSI组和SSI组[3.35(2.28,5.04)和3.36(2.53,4.94) vs. 2.64(1.89,4.06)和2.71(1.93,3.91),p<0.001]。在动脉粥样硬化性卒中患者中,BZI组的ND风险和不良预后风险最高。BZI患者和大面积梗死患者卒中后的炎症反应比MSI患者和SSI患者更强。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b713/11682303/393759d682d9/41598_2024_82862_Fig1_HTML.jpg

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