急性缺血性脑卒中患者脑小血管病总体负担与TNF-α水平及预后的相关性研究OA

Objective To investigate the association of the total burden of cerebral small vessel disease(CSVD)with the level of tumor necrosis factor-α(TNF-α)and prognosis in patients with ischemic stroke(AIS).Methods A total of 120 patients with AIS who were admitted to our hospital from January 2022 to December 2023 were enrolled as subjects,and all patients underwent cranial MRI scanning.Baseline data and TNF-α level were compared between the patients with different total burden scores of CSVD,and the correlation between TNF-α level and CSVD total burden score was analyzed.TNF-α level and CSVD total burden score were compared between the AIS patients with different prognoses to investigate the influence of TNF-α and CSVD total burden score on the short-term prognosis of AIS,as well as their value in predicting the short-term prognosis of AIS.Results There were significant differences in age,the proportion of patients with hyperlip-idemia,the proportion of patients with smoking,and the levels of TNF-α and Hcy between the patients with different CSVD total burden scores(P<0.05).The level of TNF-α was positively correlated with the number of lacunar cerebral infarcts,Fazekas score of white matter lesions,and EPV score(r=0.654,0.775,0.820,P<0.05),but it had no linear correlation with the number of cerebral microbleeds(r=-0.035,P>0.05).The logistic regression analysis showed that before correc-tion,age,hyperlipidemia,smoking,TNF-α,and Hcy were significantly correlated with lacunar infarction,white matter le-sions,EPV severity,cerebral microbleeds,and CSVD total burden score(P<0.05),and after correction,TNF-α was still significantly correlated with lacunar infarction,white matter lesions,cerebral microbleeds,EPV severity,and CSVD total burden scores(P<0.05).There were significant differences in CSVD total burden score and TNF-α between the patients with a good prognosis and those with a poor prognosis(P<0.05).TNF-α combined with CSVD total burden score had the largest area under the receiver operating characteristic curve(AUC)of 0.912 in predicting the short-term prognosis of AIS,which was significantly higher than the AUC of TNF-α or CSVD total burden score used alone(P<0.05).Conclusion The increase in TNF-α level has a certain relationship with CSVD total burden score and short-term prognosis in AIS patients,and the combination of TNF-α level and CSVD total burden score has a relatively high clinical application value in predicting the short-term prognosis of AIS patients.