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机械取栓术后24小时内炎症标志物动态变化对急性缺血性脑卒中患者预后的预测价值

Predictive Value of Dynamic Changes in Inflammatory Markers Within 24 Hours After Mechanical Thrombectomy for Outcome in Patients with Acute Ischemic Stroke.

作者信息

Zhang Baorui, Liu Aixin, Lai Tong, Wang Sisi, Lu Wei, Wang Mingxing, Zhu Yonglei

机构信息

Department of Rehabilitation, Lu 'an Hospital of Traditional Chinese Medicine of Anhui Province, Lu' an, Anhui, China.

Department of Orthopedics, Lu 'an Hospital of Traditional Chinese Medicine of Anhui Province, Lu' an, Anhui, China.

出版信息

World Neurosurg. 2025 Apr;196:123693. doi: 10.1016/j.wneu.2025.123693. Epub 2025 Feb 13.

Abstract

BACKGROUND

This study analyzes the factors influencing the 90-day prognosis of acute ischemic stroke (AIS) patients after mechanical thrombectomy (MT) and established a multidimensional risk model to predict postoperative 90-day outcomes.

METHODS

A retrospective analysis of clinical data was conducted for AIS patients who underwent MT at our hospital. A total of 111 patients who met the inclusion criteria were included in the study. Based on the modified Rankin Scale scores from follow-up records at 3 months postsurgery, the patients were divided into a good prognosis group (88 cases, 79.28%) and a poor prognosis group (23 cases, 20.72%). Receiver operating characteristic curves were plotted using MedCalc software, and area under the curve (AUC) values were calculated to establish a risk prediction model, presented in the form of a nomogram.

RESULTS

Logistic regression analysis showed that C-reactive protein (T3) (P < 0.001), National Institutes of Health Stroke Scale score at admission (P = 0.001), and a history of atrial fibrillation (P = 0.004) were independent predictors of poor prognosis, while albumin (T2) (P = 0.008) was a protective factor for the 90-day outcome. The AUC values for these factors were 0.812, 0.760, 0.655, and 0.757, respectively. The AUC value of Normotu was 0.945. Calibration slope = 0.856, calibration-in-the-large ≈ 0, and observed/expected ratio ≈ 1.

CONCLUSIONS

Post-MT C-reactive protein levels, National Institutes of Health Stroke Scale score at admission, and a history of atrial fibrillation are significantly associated with poor prognosis in these patients. Moreover, higher levels of endogenous albumin are a protective factor for the 3-month prognosis of AIS patients after MT.

摘要

背景

本研究分析了影响急性缺血性卒中(AIS)患者机械取栓(MT)术后90天预后的因素,并建立了一个多维风险模型来预测术后90天的结局。

方法

对我院接受MT治疗的AIS患者的临床资料进行回顾性分析。共有111例符合纳入标准的患者纳入本研究。根据术后3个月随访记录中的改良Rankin量表评分,将患者分为预后良好组(88例,79.28%)和预后不良组(23例,20.72%)。使用MedCalc软件绘制受试者工作特征曲线,并计算曲线下面积(AUC)值以建立风险预测模型,以列线图的形式呈现。

结果

Logistic回归分析显示,C反应蛋白(T3)(P<0.001)、入院时美国国立卫生研究院卒中量表评分(P = 0.001)和房颤病史(P = 0.004)是预后不良的独立预测因素,而白蛋白(T2)(P = 0.008)是90天结局的保护因素。这些因素的AUC值分别为0.812、0.760、0.655和0.757。Normotu的AUC值为0.945。校准斜率 = 0.856,整体校准≈0,观察/预期比值≈1。

结论

MT术后C反应蛋白水平、入院时美国国立卫生研究院卒中量表评分和房颤病史与这些患者的预后不良显著相关。此外,内源性白蛋白水平较高是AIS患者MT术后3个月预后的保护因素。

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