动脉粥样硬化性前循环急性缺血性脑卒中患者不对称突出血管征的影响因素及预后预测价值研究OA

Objective To investigate the influencing factors for asymmetrical prominent vessel sign(APVS)and its value in predicting prognosis in patients in the acute stage of atherosclerotic anterior circulation acute ischemic stroke(AIS).Methods A total of 205 patients with atherosclerotic anterior circulation AIS were consecutively enrolled.Cerebral susceptibility-weighted imaging(SWI)was completed within 72 hours after the onset of the disease,and related data were collected from the pa-tients,including National Institutes of Health Stroke Scale(NIHSS)score,early neurological deterioration(END),infarct vol-ume,mechanism of infarction,degree of responsible vessel stenosis,presence of APVS,SWI-ASPECTS score,and 90-day modi-fied Rankin Scale(mRS)score.Furthermore,the visualization degree of APVS was classified into mild(1-3 points)and obvious(4-7 points)based on SWI-ASPECTS score.Univariate analysis and binary Logistic regression analysis were used to investigate the association of the presence and extent of APVS with the prognosis of AIS patients and related influencing factors.Results Among the enrolled patients,92 tested positive for APVS,among whom 34 showed obvious visualization.The univari-ate analysis showed that compared with the negative APVS group,the positive APVS group had a significantly larger infarct volume(t=-4.325,P<0.001),a significantly higher degree of vascular stenosis(χ2=20.590,P<0.001),a significantly higher ten-dency to develop END(χ2=8.381,P=0.004),and a significantly lower proportion of patients with an mRS score of≤1(χ2=6.964,P=0.008).Compared with the patients with mild visualization of APVS,the patients with obvious visualization of APVS had a significantly larger infarct volume(t=-2.475,P=0.013),a significantly higher degree of vascular stenosis(χ2=25.648,P<0.001),a significantly lower infarction rate in the blood-supply area of the perforating artery(χ2=13.906,P<0.001),and a sig-nificantly higher tendency to develop END(χ2=4.128,P=0.042).The regression analysis showed that the presence of APVS was independently associated with END(OR=2.433,95%CI 1.097-5.397,P=0.029),and the degree of vascular stenosis was an in-dependent risk factor for both the presence(OR=4.057,95%CI 2.051-8.024,P<0.001)and severity(OR=11.25,95%CI 4.121-30.715,P<0.001)of APVS.Conclusion APVS is often observed in patients with severe vascular stenosis,and it is an independent predictive factor for END patients with atherosclerotic anterior circulation AIS.